professionalism taking a closer look at hi ......spring 2010 professionalism taking a closer look at...

SPRING 2010 www.bcshif.org

PROFESSIONALISMTaking a closer look at HI professionalism and its support

08 BENCHMARKINGA report on the Health Informatics ServicesBenchmarking Club and HI benchmarking.

12 LOOKING FORWARDAn overview of ASSIST’s aims for the planningand improvement of healthcare.

T H E M A G A Z I N E O F T H E B C S H E A L T H I N F O R M A T I C S C O M M U N I T Y

In these difficult financial times, it is moreimportant than ever that the most is madeof resources, and that includes making themost of information, information systemsand especially informatics professionals:important for the continuing provision ofhigh quality patient services. The possibilityof training embargos and budget reductions looms large with consequent

reductions in quality. This issue suggestsalternatives that need not break the bank.

Katherine Christensen describes thebenchmarking club where members cancompare their informatics services –facilities are available free of charge.

There are BCS Health events aroundthe country. The Northern Groupdescribes a recent event exploring thelatest radiotherapy targeting techniquesand the BCS annual showcase, HC2010,is coming up in Birmingham where therewill be plenty of opportunities fornetworking, hearing about and seeing thelatest developments and possibly findingthat next job. The delegate rates havebeen restructured to allow BCS membersto attend all three days for just £275. Ifyou can’t get to these sorts of events,ASSIST’S developing professional groupdescribe how they hope to use the latesttechnology and social networking sites tobring the event to you.

At such a time, it is a concern to notethat Lorenzo may not be rolled out pastrelease 2. Will this result in hospitalsfailing yet again to implement thetechnology that exists and providessupport that can improve working

ROUND-UP

practices and would be consideredessential in any commercial environment?Let’s hope not.

Matthew Swindells, the new Chair ofBCS Health, describes in an interviewhow he proposes to drive healthinformatics forward. It appears that BCSHealth has a new structure, with newpeople and renewed enthusiasm toprovide leadership for the profession.

Sheila Bullas is Editorial Board Leader of HINOW; secretary of BCS HealthInformatics Forum and director of iBECK.

Sheila Bullas, Editorial Board Leader, HINOW, provides a glimpse of what’s in store for this issue.

HINOW provides an opportunity foryou to exchange views or presentyour work. You might feel moved tosubmit an article or write to the editor. We are keen to hear from you.What do you find most interestingabout HINOW and what would youlike to see in future issues? Contact:[email protected]

WE WANT YOUR VIEWS

HINOW Spring 201002

Spring 2010 HINOW 03

08 BENCHMARKINGA report on the Health Informatics Services Benchmarking Club, whichenables HI services to evaluate and benchmark their services.

10 NURSING ASSEMBLYPaula Procter reports from Finland on the IMIA Nursing Informatics General Assembly.

12 LOOKING FORWARDAn overview of ASSIST’S activities and aims for the planning and improvement of healthcare.

14 BCS HEALTH N IRELANDBCS Health Northern Ireland was recently launched in Belfast. Paul J McCullagh reports on the event.

16 RADIOTHERAPY TARGETINGRadiotherapy technologies and their usage were discussed at a recent BCS Health Northern meeting.

19 COUNTDOWN TO HC2010A preview of this year’s BCS Health Conference, HC2010, which promises to be the biggest and best yet.

20 PROFESSIONALISMA look at different aspects of HIprofessionalism and its support.

23 EVENTS ROUNDUPA roundup of forthcoming events.

EDITORIAL TEAMJustin Richards EditorBrian Runciman Managing Editor

PRODUCTION TEAMFlorence Leroy Production ManagerMarc Arbuckle Designer

FORUM MANAGERChristine Mayes 01793 417 [email protected]

EDITORIAL BOARDSheila Bullas (leader), John Bryant,Keith Clough, Andrew Haw, Ian Herbert. Sue Kinn (News).

HINOW is the quarterly publication of BCS healthinformatics community. It can also be viewedonline at: www.bcs.org/hinow

Please note: The deadline for contributions forthe Summer 2010 issue is 5 May 2010. Please send contributions to Justin Richards:[email protected] 417 618

Registered charity no. 292786.The opinions expressed herein are notnecessarily those of BCS or the organisationsemploying the authors.© 2010 British Informatics Society Limited.

Copying: Permission to copy for educationalpurposes only without fee all or part of thismaterial is granted provided that the copies arenot made or distributed for direct commercialadvantage; British Informatics Society Limitedcopyright notice and the title of the publicationand its date appear; and notice is given thatcopying is by permission of British InformaticsSociety Limited. To copy otherwise, or torepublish, requires specific permission from thepublications manager at the address below andmay require a fee.

Printed in the UK by Interprint, Swindon, Wiltshire.ISSN 1752-2390. Volume 4, Part 3.

British Informatics Society Limited First Floor, Block D, North Star House,North Star Avenue, Swindon, SN2 1FA, UK.T +44 (0)1793 417 424 F +44 (0)1793 417 444 www.bcs.org/contactIncorporated by Royal Charter 1984.

CONTENTS

HINOW Spring 201004

The Bowel Screening InformationManagement System (BSIMS), software developed by Health Solutions Wales, ishelping to save the lives of people withbowel cancer – an illness that kills nearly

a thousand people in Wales each year.The BSIMS is a secure web application

that supports Bowel Screening Wales inthe delivery of the bowel cancer screeningprogramme.

INDUSTRY NEWS

As part of a smarter government commitment to make data more visible to the public, the government haslaunched a new data website.

Improving public and patient access to data is one of the Information Centre’score business objectives. The Centre isthe main data supplier for the NHSChoices website for patients and routinelyprovides comparative indicators forinclusion in organisational scorecards.

Empowering the publicExisting data has been made available on the website from across public sectororganisations. As a central source ofnational health data and statistical information, the NHS Information Centrehas provided over 400 data entries to thenew site. Initially, this includes recorded

hospital activity from the HospitalEpisode Statistics (HES) www.ic.nhs.uk/statistics-and-data-collections/hospital-care/hospital-activity-hospital-episode-statistics-hes and national care quality indicatorsfrom the Centre’s recent Indicators ofQuality Improvement (IQI) resource.www.ic.nhs.uk/services/measuring-for-quality-improvement

An Information Centre spokespersonsaid: ‘We welcome this newgovernment initiative, which highlightsthe increasingly important role ofinformation in empowering the publicto make informed decisions about theirhealth and other public services.’

For more information please visitthe new public website at:www.data.gov.uk

GOINGPUBLIC

HEALTH SOLUTIONS WALESSoftware developed in Wales saves lives of people with cancer

Screening processThe software supports the whole screening process, which began in Wales just over a year ago. To date over 235,000 people aged between 60 and 69 have been screened.

‘BSIMS handles the selection ofindividuals from the Welsh populationwho meet the specified eligibility criteria,’says Stephen Price, InformationTechnology Development Manager atHealth Solutions Wales.

‘Each invitee is sent a home screeningkit in the post, which is returned andtested in the Bowel Screening Waleslaboratory. The laboratory staff useBSIMS to keep track of the kits, recordthe results and produce results letters.

‘Participants with a positive screening result are referred for furtherinvestigations and are assessed byspecialist screening practitioners (SSPs). BSIMS supports this process with a clinic booking module and provides a diary and online assessmentform for SSPs.’

Saving livesBowel cancer is the third biggest killer of men and women in Wales. Bowelscreening detects bowel cancer at anearly stage, often when there are nosymptoms, and yet when treatment ismost effective.

According to the head of the BowelScreening Wales programme, HayleyHeard, the aim of the programme is toreduce mortality from bowel cancer by 15 per cent in the group of people whoare invited for screening by 2020.

The NHS Information Centre supports making public data public


INDUSTRY NEWS

A nurse has been suspended followingreports that she took photographs ofpatients having operations and then posted them on a social networking site.

Allegedly the member of staff fromSouthern General Hospital in Glasgowsecretly took the photos on her mobilephone and then posted them onFacebook. The images were spotted onthe internet by one of the nurse’scolleagues.

NHS Greater Glasgow and Clyderecently confirmed that a member of staff

has been suspended pending an internal investigation.

Appropriate actionMargaret Watt, chairwoman of theScotland Patient’s Association said: ‘Thehealth board has taken the appropriateaction by suspending the person.

‘But I would like to think that there issome kind of law where the police areable to take some action because thiswould be a breach of a patient’s humanrights and privacy.’

NHS nurse is suspended over secret Facebook photographs

FACING THE MUSIC

The UK Faculty of Health held itsAGM in February when its membersagreed with the board to establishthe faculty as a limited not-for-profitcompany. This now gives the facultyindependence from its existing sponsor and enhances the faculty’sability to create innovative think-tankstyle events focusing on its main aimof encouraging applied research anddevelopment for the benefit of UKhealthcare.

The faculty is also seekingaffiliation with BCS Health. Look outfor more events and developmentsat the faculty’s new web site at:www.ukfhi.org

The next Nursing Informatics conference will be held in Canada.

The American Medical InformaticsAssociation (AMIA) has been selectedto host NI2012, the 11th triennialCongress on Nursing Informatics.

The Congress will be held inMontréal (Québec), Canada on June23-27, 2012. For more informationplease visit: www.ni2012.org

Faculty matters

Congress update

The BCS Health Scotland Conference this year, 22-23September, will be the biggest andbrightest yet.

The event is being staged at theprestigious Glasgow Science Centrewhere attendees will not only havegreat views over the Clyde and city,but complimentary entrance to theexciting science exhibits. Thefuturistic building complements BCSHealth Scotland’s innovative andforward looking conference themes,which this year are qualityand innovation.

With an even bigger exhibitionthan last year and again featuringselected exhibits of interest andrelevance to the NHS and eHealth in Scotland, those attending can besure of an exciting conference. BCS Health Scotland would bepleased to hear of any research orinnovative work using information or IT to enhance health quality orincrease efficiency. For moreinformation please visit:www.glasgowsciencecentre.org

THE LAST LORENZO?CSC may only deliver the first two releases of Lorenzo, the electronic patientrecord system being deployed across theNorth, Midlands and East of England, underthe National Programme for IT in the NHS.

According to sources close to theprogramme, local service provider CSCwill only roll-out the releases that it hasalready received from software developer,iSoft. Gary Cohen, Executive Chairmanand Chief Executive, iSoft said thatRelease 2 – or ‘clinicals’ – had beenreleased to CSC and that Release 3 wouldbe delivered to the LSP during 2010.

It appears that CSC will roll outRelease 2, which includes care plans, ‘To Take Out’ prescribing and emergencycare, but may now not deliver modules infurther releases that were meant to

include inpatient prescribing, theatres,maternity, social care messaging and GP integration.

More flexibilityA joint statement issued by CSC andConnecting for Health, said that discussions around the scope of Lorenzoare continuing following Health SecretaryAndy Burnham’s announcement inDecember that £600m would be axedfrom the £12.7 billion programme.

The statement said that he (Burnham)‘intends to build on what is alreadyworking well in primary, acute and community settings, while givingtrusts more flexibility within theframework provided by the local serviceprovider contracts.

Is this the last release for the electronic patient record system?

Health Scotland

David Clarke, Chief Executive Officer atthe Institute, said: ‘We are delighted thatMatthew has agreed to lead one of ourmost high-profile volunteer groups. OurSpecialist Groups and Forums significantly contribute to the reputationthat BCS, The Chartered Institute for IT,

has for high-quality impartial advice, and the role it plays in enabling the information society.

‘I look forward to working withMatthew and supporting the vital andimportant work that BCS Health plays ininforming the debate around health

06 HINOW Spring 2010

NEW HEAD

informatics – a debate that affects thelives of everybody in the UK.’

Matthew said: ‘I am delighted to betaking on this role because I firmlybelieve in the role the Institute could play in improving the quality andprofessionalism of the specialistinformatics community in the comingyears.

‘This is a crucial time for informatics,and for the NHS as a whole. I am lookingforward to being a proactive ambassadorfor all branches of health informatics andBCS Health; promoting its activities andbuilding confidence in the ability ofinformatics to contribute to improving our health system.’

Matthew’s backgroundMatthew has worked in several seniormanagement roles inside the NHS,including head of information technologyat Guy’s and St Thomas’ hospital, Directorof clinical services at Heatherwood andWexham Park Hospitals when it won theHealth Service Journal’s Trust of the YearAward, and as Chief Executive at theRoyal Surrey County Hospital.

He joined the Department of Health in2006, initially as the Senior Policy Advisorto the Secretary of State, and then joinedthe NHS Management Board as theNHS’s first Chief Information Officer.Matthew is also a visiting Professor ofManagement at the University of Surreyand Chair of the charitable trustees atImperial College Healthcare NHS Trust.

What priorities do you have for the BCS post?I see BCS Health as having two priorities.The first is to help the government andthe NHS make better policy decisionsaround information and IT, to enable theNHS to maximise the benefit that informatics can bring. The second is toraise the information and IT expertise inthe NHS, both amongst informaticsprofessionals and the wider NHS staff,who should be using information to support their decision making. We will do this by engaging both at national levelwith the government and the Departmentof Health and by supporting NHS locally.

What are you keen to work on particularly?This is a crucial time for informatics andthe NHS as a whole. The challenge is forthe NHS to raise the quality of its services,whilst dramatically reducing costs. I findit hard to imagine that the NHS can succeed in doing this without the supportof information technology. I will be working to build the skills and confidenceof the informatics community to fullycontribute to this strategic challenge.

BCS, The Chartered Institute for IT, has named Matthew Swindellsas the new head of the prestigious BCS Health (formerly known asthe Health Informatics Forum). Matthew was previously the first NHS Chief Information Officer and is now Managing Director forHealth at public sector services company Tribal.

QUICK Q&A


How does your experience in theNHS/government help with this new role? I have spent 20 years in the NHS trying to improve care for patients andservices to communities through bettermanagement and the use of technology.

There has never been a moreimportant moment for the informaticsprofession to engage in the strategicdirection of their organisations. The NHSleadership has never had a betterunderstanding of the role of informationin driving quality and productivity, but,worryingly, confidence in our ability tomeet that challenge is very low.

I believe that I can use my knowledgeand experience to help BCS Healthaddress the challenge of equipping theinformatics profession to driveimprovement in the NHS from its core.

What do you make of the currentprogress being made within the NHS on IT? One of the NHS’s failures has been that it has focused too much on IT and notenough on information. Good, timelyinformation allows clinicians and

BCS HEALTH

managers to make better decisions,allows the public to hold the NHSaccountable and, ultimately, saves livesand improves care. I’d like us to spendmore time talking about how we liberatethe information that we have and lesstime talking about who supplies theboxes to hold the information.

However, you can’t ignore the NationalProgramme for IT. It is one of the mostcomplex informatics challengesanywhere in the world. It does the NHSno favours to claim either that it has beena disaster, when many real gains havebeen achieved, or that it is a triumph,when so many of the objectives havepalpably not been met yet.

I believe that the speed of change inthe NHS is so fast and the need for localownership is so great that a more flexiblesolution is necessary. The technology is

available to support this in a way that it wasn’t when the programme waslaunched and the National Programmehas changed a great deal in the past two years to reflect this.

The National Programme mustbecome ever more ‘fleet of foot’ andposition itself as a platform forinnovation, rather than the onlyacceptable way. However, it should alsobe proud of its successes and continue tostrive towards a system that joins up theinformation needed to support care.Throwing away the vision because it got difficult would be a monumentalmistake.

Some of this interview previouslyappeared on SmartHealthcare.com,Guardian News & Media’s website forinformatics professionals.

CapabiliITyRecognise and enhance the capability of your IT team.

At BCS, The Chartered Institute for IT, we understand that the information society depends on well-informed IT professionals.

We’ve developed a best practice business solution, based on the industry recognised standard SFIAplus. Designed to help IT managersidentify skills and resource gaps, it inspires high performance andsupports a structured approach to development planning.

Ensure your IT team has the capabilities to successfully deliver IT projects.

Contact us today: 01793 417 747 or www.bcs.org/solutions

Enabling theinformation society

It does the NHS no favours to claim either that ithas been a disaster, when many real gains havebeen achieved, or that it is a triumph, when so manyof the objectives have palpably not been met yet.

The HiBC enables health informaticsservices to evaluate and benchmark theirservices with those of other membersand, in so doing, identify areas for development or improvement. This is tohelp them assure the quality of what theydo and develop services they know are fitfor purpose, both now and in the future.

At the heart of the process is theBenchmarking Information Pack (BIP),which collects the data on whichbenchmarking is based. Club analystsextract the data, provide reports andshare anonymous data amongstmembers. The BIP was revised insummer 2009 and is available as anonline resource through the Club websiteat: www.hibc.nhs.uk

The HiBC also facilitates specificprojects and members have recentlylooked at such areas as customersatisfaction, infrastructure, cost ofownership, equality and diversity. Thispooling of expertise to tackle topics ofmutual interest has great potential tobenefit all members and the wider NHS.

The HiBC is managed by The HealthInformatics Service (THIS)1 based in West

Yorkshire. A governance body providesdirection and oversees development forthe club, while members help to shapeits services as it gathers momentum.

The potential of benchmarking tosupport developments in service qualityand value for money was highlighted bythe Department of Health’s InformaticsPlanning 2010/11 guidance in a call tolocal health communities (LHCs) thatthey should:

‘… review the most effective and efficientmodels for delivery of informatics and technology services to local communities to reduce the total cost of ownership oftechnology. These models should includethe shared health informatics services (HIS)approach to back office technology services.Benchmarking and accreditation of theseservices will be proactively promoted.’

The advocateJulie Rayner – Head of IM&T, SuffolkSupport Services – is one of the membersof the Health Informatics BenchmarkingClub and a strong advocate for the benefitsof joining.


BENCHMARKING

Julie said: ‘I joined the HIBC in 2009and am impressed by the professionaland encompassing way the club is run.The members themselves are active indeciding target projects for the year andare given the opportunity to participate inexisting and new projects and to educateand influence their content and direction.

‘Facilities are provided free of chargeto members and preclude the need toprocure expensive externalbenchmarking/survey services. They alsoprovide a bureau service to enable andfacilitate the sharing of good practice andthe opportunity to talk to other HISsuppliers on the challenges facing all HISservices regardless of the sector of delivery.

‘I included all my senior managementteam in the completion of BIP and thishighlighted to them all the departmentalareas where standards were being met,not being met or where they were onlypartly being met.

‘Completion of the BIP brought theseinto very clear focus and has enabled usto create an action plan to improve theidentified areas whilst maintaining andimproving standards in others.

Over 180 NHS organisations have now registered with the HIS Benchmarking Club (HiBC), with individual membership at more than 260. Katherine Christensen, Knowledge CommunitiesImplementation Manager, DH Informatics – Policy and Planning Directorate, explains about the club’s activities and ambitions.


‘Real benefits of using the BIPprovided by the club is that it is askingthe same standard questions to all HISproviders regardless of sector, it is free touse and the quality analysis is provided togive an overall result and is also split intoservice type so I could compare myservice against other shared services.

‘By completing the BIP I have alreadyachieved part of the requirement of theIM&T Operating Framework forbenchmarking the service and bycompleting the BIP and by creating andimplementing my action plan I amcontributing to my Trust’s QIPP and CQCrequirements. Other details collated forBIP are also required for the IM&TInvestment Survey and I can produceevidence to satisfy audit.

‘The other HIBC projects alsocontribute to all these national and localdirectives and the club is looking to moveforward with a national accreditationscheme for HIS services. The club hasclose links into the national areas HISservices are affected by and are able toproactively influence national thinking.’

MeasuresThe web-enabled BenchmarkingInformation Pack (BIP) is the main way inwhich data on health informatics servicesis collected and made available to theclub. The BIP shows a red/ amber/ green(RAG) status for each measure for theorganisation submitting data. The online

HIS BENCHMARKING CLUB

tool also produces spider plots and comparison reports between all organisations who have submitted data.

Critical success factor measures include:

• Who does the head of the service report to?

• Is there a published statement of the strategic direction for the service and the contribution that it will make to local health improvement and health care services?

• Is there regular dialogue between the most senior informatics post-holder

in the service and the chief executive(s)of customer organisations?

• Is the most senior informatics post-holder present at board meetings of customer organisations?

Member organisations of the benchmarking club actively take part in other activities, meetings and site visits, so that they can compare, measure and improve current systemsand processes.

1 The Health Information Service provides innovation solutions and accrediting services to clients across thehealth, social care, social enterprise and Third sectorsthroughout the UK.

The HI Service Benchmarking Club also facilitates specific projects – membershave recently looked at such areas as customer satisfaction, infrastructure, costof ownership, equality and diversity. The Customer Satisfaction Survey projecthas been repeated three times and is complete for the moment, the Service LineCosting project is in progress, the Equality and Diversity project is complete andthe following projects are coming up this year – Infrastructure, Supporting NPfITProduct Deployment and Professionalism. This pooling of expertise to tackle topics of mutual interest has great potential to benefit all member organisationsand the wider NHS.

Julie Rayner, Head of IM&T at Suffolk Support Services, said: ‘Within SuffolkSupport Services I have taken the opportunity to utilise three of the projectsavailable, the Equality and Diversity Survey, the Customer Satisfaction Survey and the BIP and have received great local benefit in doing so.’

If you or your organisation is interested in joining the club, all you need to do is register at: www.hibc.nhs.uk

PROJECT EXAMPLE

This was the last Nursing InformaticsGeneral Assembly to be chaired by RobynCarr from New Zealand. The new chairHeimar Marin from Brazil was welcomed.Robyn has been a transformational chair,in that she has facilitated the developmentof the special interest group through theskills and abilities of those around her.This has allowed individuals to take on

tasks on behalf of the group and report tothe assembly.

The assembly was very well attended;indeed the room selected proved to betoo small for all to be actively involvedand this was a problem. There werehonorary members, who are the doyennesof nursing informatics, committeemembers, country representatives,


NURSING INFORMATICS

ASSEMBLY

observers who hope to become membersand general observers.

Discussions were held under a tieredframework, in that there were those withinside information at the one extreme andthose with no or outdated information atthe other extreme, resulting in littleuseful exchange. Given that nursinginformatics is at a tipping point in terms

The International Medical Informatics Association (IMIA) Nursing Informatics General Assembly washeld in conjunction with NI2009 in Helsinki, Finland. Paula M Procter, Secretary, BCS Health (Nursing)Specialist Group and a reader at Sheffield Hallam University, explains the significance of the assemblyand provides her own personal perspective on the event.

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of advancement, it seemed to me thatthere was little ability for rapid forwardimpetus if all views needed to beaddressed.

Problems with pre-meetingsAs the meeting progressed through theagenda, it became clear that there hadbeen a pre-meeting of the officers of thespecialist group. Others may have beeninvolved, but I cannot confirm that. I haveno problem with pre-meetings as long asthey are transparent and are not used tooffer ready-made solutions to issuesexpected to arise. It will be interesting to

IMIA NI General Assembly

see how the new chair and officers workin the future. The new officers are listedon the IMIA NI website: www.imiani.org

We updated the definition of nursinginformatics, which is now:

Nursing informatics science and practiceintegrates nursing (its information andknowledge and their management) withinformation and communication technologiesto promote the health of people, familiesand communities world wide.IMIA-NI definition, adopted July 2009, Helsinki, Finland

We did not find agreement with regard toa task group I led which looked at thepossible implications of the IMIA proposalto increase the frequency of the MedInfoconference from every three years toevery two years. This is to be raised againat the next General Assembly duringMedInfo 2010. The current suggestion isalong the lines of a large NI congressevery four years with an ‘NI-Lite’ inbetween, where the special interestgroup works with a particular country toraise its nursing informatics profilethrough collaborative workshops andseminars.

Organisers updateWe received an update report from theNI2012 organisers and all appears to beprogressing satisfactorily.

The Nursing Informatics conference iscurrently held every three years and is atough task for any organising country toundertake. I think Finland had evengreater difficulties than normal, with thecredit crisis just beginning to have animpact. Others have commented onvarious aspects of the conference(HINOW, September 2009). I would like to concentrate on my impression ofacquiescence displayed at theconference.

It is widely acknowledged that nursinghas not been at the forefront of mostnations’ minds when developing newways of working with information andcommunications technology. Indeed atthe 2000 congress dire warnings weregiven of what might happen to nursing ifwe stayed silent, now that there is aninternational shortage of nurses and agrowing concern that the increasededucation of nurses has not had theimpact originally intended.

Room and boardThere is a need to move nursing outside‘room and board’ in terms of costing, andfor nursing to stand amongst equals,accepting its core role as the ‘glue’across the myriad of services patientsand their relatives and friends now procure in today’s services for health andsocial care.

My overall feeling of the papers,posters and general conversations withcolleagues was that there was a certain‘treading of water’ going on. We hadreached an impasse and although thetechnology was getting smaller and thetools getting smarter, nursing wasn’tmoving forward in the world of supportiveinformatics.

A moment of clarityIn the midst of one very low point at theconference, I decided to reconsider mynow very clouded view from a differentperspective and came away with a muchmore positive attitude.

There were individual speakers whowere demonstrating good practice inclinical nursing, education and research.Maybe the point in 2009 wasn’t so muchabout finding a nursing role, but moreabout accepting the role we have andweaving the tools of today in and out ofthe role; tools that we need to carry outthe role for the best treatment for ourpatients, their relatives and friends.Maybe we had arrived and informaticswas no longer a goal, but a living andbreathing dimension of nursing nearlyten years into the 21st century?

The importance of conferences suchas the Nursing Informatics Congress wascertainly validated in my eyes at NI2009. It challenged my thinking and although a little disappointing it has helped me re-charge my belief in nursinginformatics and availed me of additionalinformation to use in my teaching andresearch.

I thank BCS for assisting in the fundingof my attendance, as do my students.

For more information please visit theInternational Medical InformaticsAssociation Nursing Informatics websiteat: www.imiani.org

Maybe we had arrived and informatics wasno longer a goal, but a living and breathingdimension of nursing nearly ten years intothe 21st century?

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In informatics and the NHS as a whole,there is no escaping the pressures fromthe economic downturn. We are movinginto an NHS that needs to become savvierwith resources and prove the value andbenefit of investments. This is a greatopportunity for change, which, if embracedand taken full advantage of, will delivergreat benefit to patients and staff alike.With this in mind, the biggest challenge in2010 is that of ‘quality and productivity’.

Real opportunitiesThe quality, innovation, productivity andprevention (QIPP) agenda is also a hottopic and central to its success is theeffective use of informatics tools andskills. The innovative use of technologyand information and the efficient operationof IT and information services providereal opportunities to improve:

• the safety and effectiveness of care;


FUTURELOOKING TO THE

• the patient experience; • the working lives of staff; • the productivity of valuable assets.

ASSIST is keeping pace in this everchanging environment; re-energising andbringing prominence to the informaticsforum, demonstrated through the evolution of the DPG and its efforts toinfiltrate social networking platformssuch as Facebook and Twitter.

Health informatics is a fast evolving profession, critical to the effective delivery, planning and improvement of health and social care, in all its forms – IT, IS, records management, information management and information governance. With this in mind Jenny Jackson and Graeme Morgan,ASSIST Developing Professionals Group (DPG) and informatics graduate management trainees, providean overview of BCS Health ASSIST’s activities and aims in these areas.


Accessibility and modernisationASSIST is not only moving with the times,but becoming accessible to a whole newaudience. By participating in the socialnetworking revolution, we are able toinform members of any current news andinformation and give them the opportunityto take an active part in online discussions.The groups allow networking with colleagues and members, who are ableto invite others in the health care community to join them, enhancing thevisibility of ASSIST. We envisage thesocial networking groups as being another tool to unite the health informatics community.

Continuing with this modernisationtheme, we are working to make ASSIST

BCS Health ASSIST

interactive. The availability of national as well as regional events is a massiveselling point for its members, but weunderstand that individuals are notalways able to take time out of busyschedules to attend. In the currenteconomic climate, this time pressure isexpected to intensify.

Online interactionAlthough most managers appreciate thevalue of professional development,recruitment freezes and staff shortagescan make it difficult for them to releaseteam members for what they perceive asluxuries. And whilst slide shows and presentations are often made availableafter the event, they sometimes do notoffer the additional context and background that was provided on the day.However, we are now in the process ofinvestigating several technologies tofacilitate the filming of events in theirentirety and then making them availableto view online. So if you couldn’t attend oryou did, but would like to view the material again in the future, it will beavailable to you. Interactive ASSIST willnot be a substitute for attending events,but an additional benefit to meet theneeds of our members.

National conferenceDPG provide valuable support and a fresh perspective and input at national informatics events where ASSIST hasbeen showcased at, such as lastNovember’s E-Health Insider Live ’09.The forthcoming ASSIST NationalConference on 29 April will be an integralpart of the HC2010 Health InformaticsCongress at the ICC, Birmingham. Afterthat, the ASSIST stand at SmartHealthcare Live on 15-16 June 2010 atExCeL, London will act as a useful opportunity to spread knowledge andunderstanding of what ASSIST is andwhat it can do for you.

Our initiatives over the coming monthswill be fundamentally designed to continueto meet the needs of our members bydeveloping member involvement innational events and a focus onregenerating the regional branches. Wewill be providing workshops and seminarsaround issues of mutual interest such asprofessional development, de-mystifyingthe NHS and access to care records.

However, we are now in the process of investigatingseveral technologies such as podcasts to facilitatethe filming of events in their entirety and thenmaking them available to view online.

Making a differenceWe want to connect those working ininformatics and provide genuine supportto enhance networking opportunities andpersonal career development. We want tomaintain skills, exchange information,intelligence and knowledge and enhanceand share examples of good practice. Inpractical terms this will involve continueddevelopment of health informatics as aprofession. We need you, your ideas andyour input if we are to grow and developfurther into a renowned and increasinglyrecognised community in the healthinformatics world.

Getting involvedIf you are not already a member ofASSIST and would like to join you candownload a membership application formfrom: www.assist.org.uk If you are interested in getting involved with theASSIST DPG please contact the group at:[email protected]

BCS Health ASSIST is a professionalassociation for those working in and forinformatics in healthcare and socialcare. Its objective is to develop professionalism and professional standards, and to work with other bodiesincluding government to provide a voicefor informatics professionals.

The BCS ASSIST NationalConference will be held on Thursday,29 April 2010 at the ICC, Birmingham.The Conference is a major benefit of ASSIST membership, offeringboth networking and intelligence-gathering opportunities and hasgained excellent feedback frommembers in previous years.

For more information visit:www.assist.org.uk

ASSIST CONFERENCE

Health informatics in Northern Irelandwas previously organised as part of theBCS Health Informatics Forum. BCSHealth Northern Ireland is the newregional forum for knowledge sharing inhealth informatics and connected healthin Northern Ireland, with participationacross the stakeholder groups including:health and social care professionals, HSCinformatics and records professionals,government, industry, academia and service users.

The group was launched on behalf ofBCS by Jean Roberts, who also relayedconveyed best wishes from MatthewSwindells, Chair BCS Health.

State of playThe population of Northern Ireland is projected to rise from 1.71 million in 2004to 1.82 million by 2024. Over the next 20years both demographic and social trendswill bring into sharp focus the need forservices that are capable of meeting theneeds of the increased number of peoplewho will be living alone. Those servicesmay also have to cater for high levels ofsocial deprivation and the implications ofsustaining rural communities. There willalso be higher levels of disability as

people live with chronic illness. BCS Health Northern Ireland aims topromote the development and use ofhealth informatics and connected healthin Northern Ireland to support effective,efficient, evidence-based, health andsocial care in areas of research, education, practice and in managementdecision making. This is intended to benefit the health of individuals, communities and populations that receivehealth and social care services and thestaff and organisations that deliver healthand related services.

Open+HealthThe conference theme was Open+Health.It was the second of the biennialOpenIsland all-island conferences organised by open-n.i and OpenIreland.These are two multi-agency organisationswith a shared mission ‘to strategicallypromote awareness, understanding,development and uptake of free and opensource software across both the privateand public sectors, as well as enhancingthe competitiveness of the indigenoussoftware sector by exploiting the opportunities offered by open sourcebusiness models’. The conference


Launch of BCS Health Northern Ireland

comprised of invited presentations from:

• Colin Smith and Joseph Molin (World Vista), who addressed improving qualityof care using an open source electronicpatient record system. Supporting data was presented from a large population within the Veterans Association in North America.

• Peter Murray (Vice President, International Medical Informatics Association), who championed the opensource philosophy. In particular, he cited the Open Steps Project, the UK and international priorities for free/libreand open source software (FLOSS) in the health informatics domain.

• Professor Piotr Durka (University of Warsaw), who provided an academic perspective on open source authoring and collaboration for biosignal information collection, storage, retrievaland interoperability using SignalML (developed and distributed under General Public Licence v3). He also cited open source and software licence approaches to brain computer interfaceresearch, OpenBCI www.brain.fuw.edu.pl/~durka and BRAIN www.brain-project.org

BCS Health Northern Ireland was officially launched on 21 January, with a conference in Belfast. Paul J McCullagh, BCS Health Northern Ireland Committee member, reports.

From left to right: Professor Roy Harper (South Eastern Trust, Chair BCS Health Northern Ireland), Dr Liming Chen (University of Ulster), Mr Colin Smith (World Vista), Dr Jean

Roberts (representing BCS Health), Professor Piotr Durka (University of Warsaw), Mr Joseph Molin (World Vista), Dr Peter Murray (International Medical Informatics Association),

Mr Jonathan Wallace (Conference Chair, University Of Ulster), Mr Hubert Curran (European Centre for Connected Health), Mr Ger Hurl (Health Services Executive Ireland).


• Dr Howard Johnston, who demonstrated the power of Health Atlas Ireland, which provides geographical interpretation of statistical health data.

Regional perspectivesLocal and regional perspectives were atthe forefront of discussion.

• Gerard Hurl (National Director of ICT in the Health Services Executive in Ireland) discussed the challenge of providing health care in the Republic of Ireland and cited the lack of domain specialists in health informatics as a major obstacle.

• Dr Hubert Curran (European Centre for Connected Health, www.eu-cch.org) tackled the huge issue of connected health and its role in promoting well-being as tele-health solutions become more widely available. As a general practitioner, he discussed obstacles for uptake from primary care.

• Professor Roy Harper (Consultant Physician and Chair of BCS Health Northern Ireland) provided the case for preventative health care, particularly in

BCS Health Northern Ireland

his specialist area of diabetes care. He discussed the significantly increased incidence of chronic diseasesand conditions, which presents a huge challenge globally. He went on to say: ‘We will have an ageing population, significant rising cost of managing chronic disease and finite resources to provide that care. Hence the development of cost-effective, open and connected health service solutionsto meet users’ needs will be core to maintaining and improving the quality of healthcare and the quality of life for the people of Northern Ireland.’ He then went on to cite collaborations withacademia and health users as being important to this collaborative approach.

• Dr Liming Chen (University of Ulster) provided an academic perspective of assisted living applications and described projects that are already benefiting the local population with partnerships with FOLD telecare and The Cedar Foundation.

• Jonathan Wallace (University of Ulster’s Director of Knowledge and Technology Transfer in the Faculty of Computing and Engineering)

explained that computer technology will have an increasingly important role to play in healthcare services as Northern Ireland and the world’s population rises and ages over the next 20 years.

The conference was attended by approximately 150 people and broughttogether key stakeholders in connectedhealth from the health trusts, academia,industry and government to share theirknowledge and experience of using openand connected technologies to improveservice delivery and health and well-being.

Participants were also invited to takepart in a summit workshop (22 Jan at theUniversity of Ulster), which provided anopportunity for decision-makers toaddress key questions on the futurestrategy of open and connected healthdelivery and its evolution across aregional, national, European and globalcontext and move the discussion towardsspecific recommendations and actions.

For more information about BCS HealthNorthern Ireland please visit:www.bcs.org/health/ni

Chris Moore began by giving a virtualintroduction to the team of four in theNorth Western Medical PhysicsDepartment (NWMP) of The ChristieHospital, and then gave a brief history ofhow imaging and therapy parted ways forsome time following W. C. Roentgen’s popularised discovery of X-rays in 1895.Indeed photography and X-ray parloursgave the public the chance to acquire pictures of themselves inside and out.Radiotherapy treatments were reportedon from 1896 onwards.

Cancer cellsMoore moved on to talk about cancercells, explaining that they were not

‘programmed’ properly, and they did notbehave like other cells. One characteristicis that some kinds die much more easilythan healthy cells when they are exposedto radiation. Normal cells were likened toprize fighters, they keep getting up againwhen they have been knocked down andthey will recover time and again, whereasrepeated blows will kill off the cancercells. This difference between cancerousand normal cells provides what is termeda ‘therapeutic window’.

Single CAT scans have been used forplanning radiotherapy since the late1970s. Algorithms to determine theradiation dose distribution to be deliveredto a tumour require the body surface, the


RADIOTHERAPY TARGETING

target position and the shape of thetumour to be explicitly defined asgraphical constructs. Similarly, organs atrisk in the vicinity of the tumour need tobe defined as graphical structures.However, despite this exquisitecomputerised planning detail, it is stillcommon simply to mark the patient’sbody surface with indelible ink to indicateto the radiographers where to direct thetherapy beams once the patient is in thetreatment room.

Image guided radiation therapy (IGRT)has finally taken X-ray imaging directlyinto the treatment room – but only in thelast few years. Various imaging methodshave been deployed to get better images

Radiotherapy technologies and their usage were discussed at a recent meeting in Manchester which featured speakers Professor Chris Moore from North Western Medical Physics, at The Christie Hospitaland Professor Dave Burton from the General Engineering Research Institute at Liverpool John MooresUniversity. Phil Paterson, who also chaired the proceedings, reports.


to help the delivery of radiation to thepatient. With each new method it seemsthat more and more data is beinggenerated. A typical breast cancer patientcan have 15 visits during a course oftreatment, which has the potential toproduce huge amounts of data.

A few figures put things into perspective:A 100-slice CT scan produces 39 Mb ofraw data and 53 Mb (512x512x100 -16bits)of reconstructed data.

CAT scansCone-beam CT reconstruction, invented in 1984, produces contiguous volumes ofimage data. Two decades on it is now beingwidely deployed for cancer treatments.The technique begins with rotation fluoroscopy to form a 2D-projectionsequence. To get the desired image quality for a 1024x1024x1024 3D reconstruction requires around 7681024x1024 X-ray projections. That’s 0.81

RADIOTHERAPY

GB of 16 bit raw projection data and 2.14GB of reconstructed volumetric data eachtime cone-beam scanning is used. Theinstalled Christie computer systemscould not handle this amount of data sothe team had to build their own systemwhilst waiting for viable commercial solutions. At the moment this techniqueis only used for a small proportion of thethousands of patients seen annually atThe Christie, but this will inevitably grow.

The whole point of what follows is totarget more accurately the area to receivethe radiation and to limit the exposure ofthe surrounding healthy tissue tounnecessary radiation.

CAT scanning and treatment planningcalculations are not done in thetreatment room and are not dynamic.They are performed prior to the arrival ofthe patient in the treatment room itself.However, during treatment, the tumour isconstantly in motion – the patient hasphysiological motion: they breathe, haveheartbeats etc. There is no such thing asthe patient remaining perfectly stillduring treatment even withimmobilisation devices. All of whichmakes it hard to set up the patient andaim the treatment beams at the tumourtarget.

Ideally, imaging should be dynamic andperformed during both patient setup andtreatment. With X-ray imaging, thetherapy radiographers cannot of course bewith the patient in the treatment room.

The clinical needs of an imaging tool,complementary to X-ray imaging, are thatit should:

• show 3D body shape and position;• provide images on demand;• be radiation-free;• work before, during and after

irradiation; • be dynamic, even having a real-time

capability;• have millimetre accuracy.

In 1993 Professors Moore and Burtonconcluded that there was an optical solution.

Optical solutionDave Burton took the floor and began totell the meeting about how they wentabout tackling the problem that ChrisMoore had described.

It was agreed that what was neededwas something which could measure theshape and position of the patient on thebed. The constraints were:

• there must be no contact;• it must not interfere with the treatment

itself;• it must be relatively easy to use;• it must be robust.

The team decided to employ an approachknown as ‘structured light’. A highlystructured light pattern is projected ontothe patient’s body surface and it is viewedoff-axis with a digital camera. Thepatient’s body shape will modulate thestructured light as observed by the camera.As the original structure is known andthe modulated image can be captured, itis possible to work out the modulatingfunction i.e. the patient’s shape.

The Mark 1 SensorThe Mark 1 Sensor was based on a lasertwin-fibre interferometer. The two professors used a helium-neon opticallaser and split the laser beam into astripy (venetian-blind type) pattern. Toovercome the uneven intensity of the lightbeam – it is brightest in the centre anddiminishes at the fringes – they used apiezo actuator, which moves the stripesof light back and forth very fast. Theysolved the problem of reconstructing allthe parts of a 3-D sliced model of a bodyusing a technique called Fourier transform profilometry. An importantstep in this process is the so-called‘phase unwrapping’, in which theybecame world leaders.

The team tested the sensor on astudent and they were able to create a 3D model of the student’s back from thestripy pattern of light. From here, in themid-90s, they were able to move totesting it on real patients. NWMP thendeveloped a method to dynamicallyreconstruct the live body surfaceaccurately enough to see the patientbreathing and even reveal the heartbeat.

The sensor was used in clinical studiesat The Christie, specifically on breastcancer patients, and it lead to someextremely interesting results. At this pointthey had the fastest, most accuratesensor in use in radiotherapy, but felt thatthings could still be pushed further. In

A typical breast cancer patient can have 15 visits during a course of treatment, which has the potential to produce hugeamounts of data.


particular they wondered if they could doit in real-time while the patient was beingtreated, but that would require morecoverage and more speed. It would requireat least a 270 degrees arc of view with a40cm3 field and something approaching avideo frame-rate (about 25 frames persecond) with a start/stop button.

The only way to achieve the 270degrees arc would be to have more thanone camera with overlapping fields ofview. In fact they would need threecameras and they would need threesensors. These multiple channels wouldhave to be optically separated and thesensors would have to be networked andoperate synchronised and in co-operation,so that each sensor only saw its ownstripy pattern. Given the enormouscomplexity of one sensor, this was goingto be a tall order. Three years ago they setout to build such a system.

The multi-sensor images ‘snaptogether’ into a 3D model. In the clinic,three sensors are in place, one above thepatient’s feet, another on the right-handside and a third one on the left-hand side.

Guided radiation therapyBurton then handed the floor back toChris for an overview of the use of opticalsurface sensing for image guided radiation therapy.

Early testing suggests that the tripleoptical sensor system is accurate to amillimetre or so, which is comparable tothe accuracy of patient cone-beam CTscans. The system is now generating upto 270 GB of data per patient for fiveminutes of use. Since a course oftreatment can easily be 15 daily fractions,the challenge to future networking anddata storage problems is obvious.

North Western Medical Physics at TheChristie is now using custom-builtterabyte computers on a special network,but it is necessary to find a way torationalise the amount of data produced.The Christie currently cannot handle thisvolume of data over its established NHSPACS network. Government advisors havesaid that image guided adaptiveradiotherapy should become a nationalstandard of care, which of course hashuge implications for IT infrastructure.

Funding and support is still needed tocontinue working with optical sensorsbefore they can become universallyavailable with anything like theperformance achieved in the studies byLiverpool John Moores University and The Christie. Inside out, live, and whilethe patient is being treated, is the goal.

For more information about radiotherapygo to: www.radiotherapy.in/mssd

RADIOTHERAPY

The multi-sensor images ‘snap together’ into a 3D model. In the clinic, three sensorsare in place, one above the patient’s feet,another on the right-hand side and a thirdone on the left-hand side.


This three day event, (27-29 April), hasundergone a series of changes to ensureit remains one of the most significantevents in the health informatics calendar.

This year’s registration processincorporates the latest barcode andmobile technology to automate andstreamline the registration process.Delegate rates have also been altered inrecognition of constrained budgets and toenable attendees to benefit from theirmembership of BCS, The CharteredInstitute for IT, which owns and runs HC.

Exhibitor presentations are expected tobe more closely integrated into theconference and there are plans for a new‘careers zone’ that offers one-to-onesessions for health informaticsemployees or other NHS staff looking fora career in the industry.

Mike Sinclair, head of the HC2010organising committee, says: ‘We are verypleased that the new-look HC2010 is tobe complemented by the new registrationtechnology. HC2010 will showcase someof the best and most current technicalsystems, services and solutions used tosupport care and treatment in the worldtoday. As well as current best practiceand examples of leading-edgetechnology, the conference will includecontributions from policy makers andexamples of innovative strategic andtactical practice across the world ofhealth and social care informatics.’

Conference programmeThe conference programme comprises

The countdown to the start of HC2010, the largest health and socialcare informatics congress in Europe, has begun. Christine Connelly,CIO for Health and David Behan, Director General of Social Care atthe Department of Health, are among a number of high-profilespeakers who have agreed to attend this year’s event in April at theInternational Conference Centre, Birmingham.

12 streams looking at a wide range ofissues relevant to health and social careprofessionals. There will be a case studyon the UK’s first NHS/local authority integrated ICT service (between NHSHerefordshire and Herefordshire Council),as well as interactive workshops aboutinformation and its relationship with thedelivery of care, hosted by BCS Health.Speakers from Bristol Royal Hospital forChildren will also talk about the lessonslearned in developing a knowledge sharingculture across the NHS.

Delegates will be able to contributetheir views during an interactive cafédiscussion about informatics as aprofession and how it should berecognised for the critical role it plays inthe delivery of a modern, safe, highquality and value-for-money healthservice. This session will be led by DiMillen, Head of Informatics DevelopmentDepartment for Health’s Informatics,Policy and Planning unit.

Additional speakersOther confirmed speakers include JimEaston, National Director of Improvementand Efficiency and Professor Heinz Wolff,Founding Director, Brunel Institute forBioengineering. Also speaking will be DrAiden Halligan, Director of Education atUniversity College London Hospital,Professor Michael West, Executive Deanat Aston University, as well as ChristineGoodfellow, Director of the ImprovingInformation Sharing and ManagementProgramme at the Department of

Children, Schools and Families. ASSIST (Association for Informatics

Professionals in Health and Social Care)will hold its National Conferencealongside HC, at the Centre, on 29 April.

New delegate ratesDelegate rates for HC2010 are as followsand each includes the full three days plusthe cost of the event’s gala dinner, thisyear held on the first evening of HC2010.

• Delegates working in the public sector who are not BCS members, will be charged £450¹;

• Delegates who are BCS members will be able to attend for £275;

• The cost to ordinary delegates is £625; • Student rates are £275 for two or more

days, or £175 for one day;• Non-BCS members could benefit by

signing up for BCS membership for as little as £36. See: www.bcs.org/membership

Mike concludes: ‘Now, more than ever, itis vital for each of us in the informaticscommunity to network with other colleagues and make connections withsuppliers. We are aiming for HC2010 toprovide a unique opportunity to learn, share,debate and network, all under one roof.’

To view the full programme, or toregister, see: www.hcshowcase.orgDelegates should go to the delegate zonesection of the site to register.

¹Please note: Delegate rates are subjectto a VAT rate of 17.5%.

HC2010

The Career Zone has been designed to offer:

• career support using the Health Informatics (HI) CareersFramework; delegates will be offered the opportunity to have a one-to-one session, aimed at current HI employees or other NHS staff looking for careers in HI;

• tutorials to see the HI Career Framework in action, using case studies;

• the chance to see how the HI framework can assist in recruitment and retention;

• the opportunity to publicise the various career routes into HI aimed at students from sixth formcolleges, further education and higher institutions.

THE CAREER ZONE

COUNTDOWN TO HC2010

Health informatics (HI) is an emergingarea but there have been individualsdesigning, delivering and running informatics solutions, carrying outresearch and ensuring that the end-usersare positioned to use the systems effectively and efficiently, since the late1960s. However, only relatively recentlyhave there been significant moves to create a holistic community and put in

place the rubric by which the constituencies within the profession(s)can move forward.

There are a number of stakeholderorganisations in the HI space, currentlywith some functional overlaps, includingBCS Health, UK Faculty of HealthInformatics, UK Health InformaticsSociety and UK Council of HealthInformatics Professions. A collective


PROFESSIONALISM

review involving many of theseorganisations is looking to rationalise andcreate clarity across the community.

Value to the individualThe multi-dimensional health informaticscommunity contains eight main constituencies (ICT, information management, knowledge management,portfolio/programme/project managers,

Codes of conduct that recognise effective information handling are infrequently seen in health.Individual professions have specific responsibilities with respect to handling sensitive data or the systems which provide such information to support decision-making. However, there are some practices that should apply generically. Jean Roberts looks at different aspects of professionalism andsome of the tools currently available to support its development.


clinical informaticians, education/training/development/research staff,health records personnel, and those who manage health informatics services)each with a particular focus. Individualswill be asked to relate to one home constituency, but that relationship maychange over time as their career develops. The NHS HI Career Frameworkwww.hic.org.uk developed across thehome countries, describes typical jobroles at progressive levels in a matrix,which individuals can use to inform whatpotential next steps in their developmentcould entail.

By reviewing current and possibletarget job roles an individual candetermine whether they are ‘equipped’ to

PROFESSIONALISM

do the role they are considering applyingfor and if not they can see where theyneed to gain more experience orqualifications to maximise likelihood ofsuccess in an application.

Registering with the UK Council forHealth Informatics Professionswww.ukchip.org strengthens anindividual’s position. Each registrantdemonstrates their commitment toadhere to a code of conduct andcontinuing professional developmentrelated specifically to the healthinformatics domain. Increasinglypotential employers will be looking forsuch a commitment, as is the casealready in Wales. There will be hybridprofessionals who also have professionalresponsibilities and developmentopportunities to other professions; suchas the knowledge managers to theChartered Institute of Library andinformation professionals or BCS as The Chartered Institute for IT. A personal eclectic mix of registrationscan strengthen the commitment to professionalism and provide the potentialfor mobility throughout the specifichealth domain.

Value to the organisationThe same data that is used to describetypical job roles via the CareerFramework can be used by an employerto project their overall resource needsand map existing staff against that profile, to identify areas where the organisation could be lacking in skillsand competence. This exercise can initiate a recruitment exercise with aclear brief to reduce the gaps or increasespecific resources in a particular developmental growth area. Alternatively,it can indicate a need for re-orientation of teams as demand for informatics tosupport health changes over time.

Upcoming areas of demand includetechnical expertise in businessinformation analysis for strategicpopulation profiling, competence tosupport future connected health(telemedicine-related) projects andcomplex programme management ofmultiple projects at local levels. Potentialemployers are increasingly aware thatregistered HI professionals are

recognised by their peers and will carryout personal development in order to stayup-to-date.

Languages of professionalism In a complex multi-employer landscapelike health, operational public sectorhealth and social care, commercial solution and service provider and academic/research organisations compete for scarce qualified and experienced people. Consistent, comparable ways of describing achievements facilitate a level playingfield for both potential employers andemployees.

The case for distinctive domain-specific factors within healthinformatics has been well-made. Thereis, and will continue to be, movementboth in and out of the community in orderto meet escalating demands forinformaticians. Skills requirements andpersonal competences must becontinually mapped from generic profiles(e.g. Skills framework for the InformationAge, BCS IT membership/fellowshipcriteria and the Skills for Health NHSNational Occupational Standards) to theexpression of the NHS CareerFramework and UKCHIP’s standards tofacilitate comparison and levelling.

Potential employers are increasingly aware that registered HI professionals arerecognised by their peers and will carry out personal development in order to stayup-to-date.

UKCHIP has been established topromote professionalism in healthinformatics and the certification ofthose who work in the profession. It operates a voluntary public registerof health informatics professionalswho meet clearly defined standardsof competence and agree to work toa common code of conduct. UKCHIPprovides an independent but synergistic domain-specific functionto that of BCS Health. BCS Health isa domain-specific entity within BCS,the objectives of which address boththe promotion of the academic discipline of IT and the needs of theprofessional body (furtherance of the IT profession) per se.

UKCHIP


PROFESSIONALISM

The same standard expressions shouldbe used for both NHS and third party HIprofessionals to ensure parity. Furthercredentials such as Chartered status(CITP, CEng, CSci) may be achieved laterin a career. Pre-accredited academiccourses or personal portfoliosubmissions of experiential evidence canbe used to demonstrate continuingfitness to practise.

An individual’s value to a potentialemployer must be understood andassessed appropriately. An area ofcurrent risk is that the contribution ofsuch diverse expressions of competencesis not fully understood or consistentlyinterpreted by employers. More work isneeded to ensure professionals areconsidered equally for new posts.

Complexity of applicantsJob applicants come both from within the HI domain and increasingly fromother sectors because of developmental decisions or through the downsizing ofother institutions. This can lead to applicants responding to recruitmentadvertisements and competing for positions for which they may be

The Green IT qualification

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over-qualified. It can be a difficult judgement call.

Some health professionals maydevelop tangential interest in informatics,hence enhanced informatics componentssuch as formal project management ortechnical standards may be a necessaryaddition to their CV. The CareerFramework and the upcoming UKCHIPonline tools will help discussions atpersonal development planning meetingswith line managers, whether theindividual is at the start of their HI careeror well into it.

How to plot your professional courseUKCHIP is defining specific standards tobe demonstrated by a mix of the above foreach of its levels of registration. These willadditionally, through online tools supportany individual wanting to assess the typesof jobs that they may be eligible for.

It is intended that subsequent versionsof the tools will also provide guidance tocandidates on how their skills might beenhanced through academic educationalor commercial training courses.

Using the Career Framework as a roadmap, users can log their development

activities, from presenting, writing andcommenting through to attending groupmeetings, providing work-basedassistance to colleagues and keeping upwith appropriate web feeds, all of whichcan ultimately help prepare them forsuitable job roles when they appear.

On reflection In the March 2009 edition of HINOW, I asked whether the health informaticsprofession was growing up. It has definitely developed, but is still notmature. As the Developing ProfessionalsGroup of ASSIST indicates, we all mustdo more to share experiences, knowledgeand work towards a brand identity.

Please watch out for discussions onLinked In (groups such as BCS HealthInformatics Forum, UKCHIP and ASSIST),on the eSpace area and through the UKFaculty of Health Informatics, in additionto reading HINOW.

Jean Roberts is a Senior Lecturer inhealth informatics at the University ofLancashire and is a board member ofUKCHIP and the UK Faculty of HealthInformatics.


EVENTS

April 2010

BCS Health Northern22 April 2010

Health Informatics for PatientsManchester Conference Centre, Days Hotel

www.hinorth.bcs.org.uk

BCS Health27-29 April 2010

HC2010 ConferenceInternational Conference Centre,

Birmingham

www.hcshowcase.org

BCS ASSIST 29 April 2010

BCS ASSIST National ConferenceInternational Conference Centre,

Birmingham

www.assist.org.uk

MAY 2010

PHCSG Summer Conference24-26 May 2010

Health and Efficiency - Improving Services in anEra of AusterityChesford Grange, Warwickshire

www.phcsg.org.uk

ASSIST North West Branch27 May 2010

Building a Business Case - Tools and TechniquesUniversity of South Manchester

www.assist.org.uk

June 2010

ASSIST North West BranchSecond half of June. Date: tba

Digital DictationVenue: tba

www.assist.org.uk

July 2010

Nursing Specialist Group19-24 July 2010

Summer Institute of Nursing InformaticsUniversity of Maryland School of Nursing,

Baltimore, USA

http://nursing.umaryland.edu/calendar/event/2677

September 2010

International Medical InformaticsAssociation (IMIA)12-15 September 2010

Medinfo 2010Cape Town

www.medinfo2010.org

BCS Health Scotland22-23 September 2010

BCS Health Scotland ConferenceGlasgow Science Centre

www.glasgowsciencecentre.org

ASSIST North West BranchDate: tba

Electronic Management of Health RecordsJoint meeting with West Midlands Branch

Venue: tba

www.assist.org.uk

THE FUTURE OFINFORMATICS 2010

ICC Birmingham27-29 April

HEALTH INFORMATICS CONGRESS

The UK’s largest, most powerful and rewarding event for health informatics and social care professionals.

A new international standard venue, an exhibition packed with leading HI companies, a fresh approach to networking opportunities,

more service and clinically based content, and a more dynamically structured conference programme. HC2010 Health Informatics

Congress – the event at the cutting edge of informatics in healthcare.

Find out how you can get involved in HC2010 at

www.hcshowcase.orgFor all enquiries contact Citadel Events 01423 526971

HC2010 CONFERENCE• ‘Achieving Quality, Innovation and Productivity’

12 whole day streams

• Confi rmed contributors include:

- Christine Connelly, CIO for Health - Jim Easton, National Director

of Improvement and Effi ciency - Gwyn Thomas, CIO for Wales

- David Behan, Director General of Social Care

- Professor Emeritus Heinz Wolff, Founding Director, Brunel Institute for Bioengineering

• The BCS ASSIST National Conference runs alongside HC2010 on Thursday 29 April

HC2010 EXHIBITION• A unique opportunity for companies and

organisations to interface direct with key decision makers in the NHS

• Companies whose primary focus is the development of healthcare informatics systems and products designed to enhance and improve patient care

• High level of interest in the exhibition with prospective and existing exhibitors viewing HC2010 as the health informatics event of the year, and being prepared to invest to attend

• HC2010 provides a unique opportunity to learn, share, debate and network, all under one roof

TO SEE THE CONFERENCE PROGRAMME & REGISTER AS A DELEGATE ONLINE VISIT THE WEBSITE

TO BOOK STAND SPACE OR TO REGISTER AS AN EXHIBITION VISITOR, VISIT THE WEBSITE

O R G A N I S E D B Y:M E D I A PA RT N E R :

professionalism taking a closer look at hi ......spring 2010 professionalism taking a closer look at...

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