Health Informatics in 2018 -a Re-energised Profession? Gwyn Thomas Predictions Leadership Aspirations.

Health Informatics in 2018

-a Re-energised Profession?

Gwyn Thomas

• Predictions• Leadership• Aspirations

"Prediction is very difficult, especially if it's

about the future.”Nils Bohr

2006 Remote healthcare access Implanted or attached wireless sensors Global on line consultationsExchange of medical records, Accessible to patients

2007 Doctors will get enhanced “super-senses” to better diagnose and treat youAn avatar – a 3D representation of your bodyVisualisation of medical recordsAutomatic comparison with thousands or hundreds of thousands of other patient records, More precise in diagnosing and also treating you, based on people with similar issues and makeup.

IBM’s 5 in 5 Predictions for Healthcare

You will have a crystal ball for your health A personal genetic map that tells you what health risks you are likely to face in your lifetime andthe specific things you can do to prevent them,

Pharmaceutical companies engineering new, more effective medications that are targeted for each of us as individual patients.

2008

2012

2011

2009 Cities will have healthier immune systems Public health officials will know precisely when, where and how diseases are spreading – even which neighbourhoods will be affected next.

We will see a "health Internet" emerge, where anonymous medical information, contained inelectronic health records, will be securely shared to curtail the spread of disease and keep people healthier.


Mind reading is no longer science fictionHeadsets with advanced sensors to read electrical brain activity that can recognize facial expressions,excitement and concentration levels, and thoughts of a person without them physically taking any actions.

Doctors could use the technology to test brain patterns, possibly even assist inrehabilitation from strokes and to help in understanding brain disorders, such as autism. .

Digital taste buds will help you eat smarterHelp us eat healthier, creating novel flavor combinations that will make us crave a vegetable casserole instead of potato chips.

Not only will it make healthy foods more palatable -- it will also surprise us with unusual pairings of foods actually designed to maximize our experience of taste and flavor.

In the case of people with special dietary needs such as individuals with diabetes, it would develop flavors and recipes to keep their blood sugar regulated, but satisfy their sweet tooth.

2013

Doctors will routinely use your DNA to keep you wellToday, full DNA testing to help make treatment decisions is still rare. But cognitive systems and cloud computing may make this form of treatment mainstream.

It could be done faster, more affordably and much more frequently. In addition to DNA testing for cancers, we may even see DNA-specific personalized treatment optionsfor conditions such as stroke and heart disease.


Meanwhile ...back on Planet Earth

A Backwards Glance at NHS IT Programmes.......

1990 20182000 2010

NATIONAL

NATIONAL

LOCAL LOCAL

NATIONAL

NATIONAL

NHS IT STRATEGY 2018

Paperless NHS

Caldicott 2 Review

However, the review panel concluded that although services based on these new and emerging technologies may create some operational challenges, they do notrequire any additional information governance principles. The personal confidential data gathered through these new processes and technologies must be treated in the exactly the same way as any other personal confidential data, and providers of these services must adhere to the existing legislation and best practice on protecting and appropriate sharing of personal confidential data

Information Governance Review - A Changing World??

New and Emerging Technologies - “Virtual Consultations with a clinician, using the telephone, emails or video”

First email1971

First Video Recorder1950s

First Phone Call 1879

• “Diverse Solutions & Local Leadership”

• “Support a Modern Workforce” - Nurses, porters, consultants, receptionists, scientists, therapists

and many others

• Exploit the Information Revolution

• National Systems will be the electronic glue• Local systems, locally chosen but compliant with interoperability

and data standrads

• Comprehensive transparency of performance data• NHS accredited health apps

• Fully interoperable electronic health records• NHS number for safety and efficiency will be used in all settings• On Line GP appointments and repeat prescriptions

• Data Analytics for Research & Population Health

• Avoid accidental ageism and Close the Digital Divide

“Combinatoria

l Innovatio

n”

• Introducing Healthcare IT is complex and difficult. We’ve tried ….• big bang, • incremental, • national, • local, • heavy central investment and delivery• small scale distributed local expenditure,• ruthless standardisation, • market driven free for all.

• Absence of policy and strategy has never been the problem

• Technology changes faster than the NHS can cope with

• Almost everything that has been promised works somewhere - but none of it works everywhere

• Every failure has damaged the reputation of Informatics Professionals

• When things ‘go wrong’ the solution is to tighten controls and ‘Governance’

• The NHS finds it very difficult to embrace standardisation

• The NHS finds it very difficult to exploit innovation.

So, what can we conclude??

1990 20182000 2010

NATIONAL

NATIONAL

LOCAL LOCAL

NATIONAL

NATIONAL

NHS IT STRATEGY 2018

Informatics Professionals

“Informatics Professionals are fundamentally

incapable of becoming Leaders”

Federation for Informatics Professionals

Fed- IPThe Federation for Informatics Professionals

Nature Nuture Experience

? ? ?

Nature

?

A Recent Exercise in Transactional Leadership

YES

NO

• We need you! • Tragedy to break up the UK

Family. • The Scots are brilliant, no really

they are, they’ve changed the world

• It’s our country too!

BUT THEN, NO BECAME….

LEADERSHIP IS ‘RIGHT BRAIN’

INFORMATICS IS ‘LEFT BRAIN’

“Action must be preceded by Order and Organisation”

It’s not just that everything has to HAVE a place,

- everything has to be IN its place - before anything can be done.

THE 1st LAW OF INFORMATICS

Nature

What if Informaticians worked in the Motor Industry?What would the 1st Law of Informatics Predict?

Who would be qualified to use it? Which roads would it go on? How would it be licensed? Would people have to pass a test? What happens if it crashes? Who’s liable on the insurance?

Above all

Where on earth would they put their hands?

Nuture

?

Entry into the Profession? - “Accidental”Professional Bodies? - FragmentedProfessional Registration? - IndifferenceProfessional Membership - Passive

Report to the CEO? - Very RareSeat on the Board? - Very RareLeadership Role? - Very RareStrategic Role? - SometimesSupporting Role? - AlwaysOperational Role? - Always

The Informatics EnvironmentProfessional and Organisational Leadership

• Very Intelligent• Masters in their own environment• Struggle to succeed outside it• Find it difficult to communicate with Humans

The Informatics EnvironmentThe Perception of Others?

The Language of Leadershipor more Dolphin-speak?

“Combinatorial Innovation”

The Dolphin Effect

“The Lost Tribe”

The Informatics Environment

What’s most important to Health Informatics Staff …..?

VOICE RECOGNITION

“What do we want?” “Recognition!”

When do we want it? “Too soon to say!”

The 1st Law of Informatics!

Nuture

Experience

?

“In the mean time, if you have to go to hospital and if your name is Smith, Jones, Patel or Mohammed, be afraid, be very afraid”. Joe McDonald CCIO

6 NHS National IT Strategies

Since 1992

EHI Posts from Informatics Professionals ……•It’s essential•The Suppliers just won’t do it•The Scots have done it•No they haven’t, it’s SCI•It should be mandated•It has been – twice!•It’s easy, just get on with it •It’s difficult, don’t be too hasty•The number is too long for my PAS so we use our own•14 digits is too long – invent a shorter, intelligent number

“What do we want?”

“The NHS Number!”

When do we want it?

“Not yet!”

The 1st Law of Informatics !

In 22 years the Informatics Profession has failed providethe collective leadership to

do what clinicians see as absolutely necessary and patients see as ‘the bleedin’

obvious’.

Experience

“The ‘No

Leadership’Tribe”

Nature Nuture Experience

The only logical conclusion that can be drawn is that Informatics is

“The Lost Tribe” because it’s …..

“2018 – A RE-ENERGISED PROFESSION”

FEDERATION FOR INFORMATICS PROFESSIONALS (FED-IP)

Our Aspirations


Fed- IP

LeadershipKnowledgeStandardsCode of EthicsRegistrationRegulationRepresentationReputation

MaintainingPublic Trust in the Duty of Care to Share PersonalInformation

Informatics Professionalism - More Important than ever.


UKCHIP, BCS, IHRIM, SOCITM


Fed- IP

What is Professionalism?

• Practice

• Standards

• Behaviours

• Ethics

• Development

Registration

Developing Skills

Recording Skills

Proving Skills

Validation &

Regulation

“You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.”

“Doing the Right Thing… When No-one is Looking”


Fed- IP

Where are we now? - HI Professional Reputation

Where are we now? – Professional Leadership

• The existing landscape of national organisations representing Informatics Professionals is characterised by – duplication of functions, – overlapping roles and responsibilities– organisational rivalries– fragmented leadership

• Approx 20,000 – 60,000 HI Professionals – but only 4,000 actively registered

• Professional Membership - Unclear purpose and benefits• Professional Registration – Lack of clear Policy position

• There are gaps - the most important being the absence of a voluntary regulatory framework that will ensure not only that the highest professional standards and codes exist but that they are also adhered to in practice


Fed- IP

What is proposed? – Federation for Informatics Professionals

National Health & Social Care Informatics Professional Organisations working together to ensure consistency in professionalism across all health informatics areas of the NHS•Clear Value Propositions for all•A ‘front door’ that supports the individual to join and participate•Simplified membership & fee structure

•National Public Register to provide assurance for Employers and Patients•Professional Development linked to

• Personal Career Plans• Organisational Objectives

•Growing the Membership•Increasing Influence•Building Reputation


Fed- IP

Consultation - What you told us (1)?

Wide Representation

You would like as wide as possible within the Federation to ensure it is not dominated by one group within the healthinformatics domain.

You believe that the best value and biggest impact will come from a range of different people working in different aspects of health IT and informatics and not just from one dominant perspective


Fed- IP

What’s important to you?

•Independent Voice for Policy & Professionalism

•Skills Framework and CPD

•Professional Recognition

•Recognition that health informatics is integral to the delivery of better, safer care

Consultation - What you told us (2)?Federation for Informatics Professionals

Fed- IP

What are our aspirations?

Independence

•Free to set standards that best serve patients and the public in collaboration with interested parties

•Able to provide the single coherent platform and voice to represent the collective views of all lnformatics Professionals to the public, government, and employers

•Provide objective assurance that contributes to maintaining public trust in the delivery of public services


Fed- IP

2018?

Inclusivity

•Recognising the variety of specialties within health and informatics, which is a broad discipline covering the NHS, Social Care, Academia and the private sector

•Each professional member accepting that collaboration is the only credible approach to further the professional standing and reputation of individual of health and care informatics professionals


Fed- IP

2018?


Sustainability

• Building an active and involved membership committed to developing, sharing and exploiting the informatics knowledge base for the common good

• Serving and supporting individual members with services and professional education and development to gain and maintain professional registration

• Working with other professional bodies to explain and promote the value of informatics in the delivery of safe care


Fed- IP

2018?


“Your professional reputation is determined

by the lowest standards that you tolerate

not the highest you have achieved”

Re-discovering Professionalism- Where’s the Leadership Going to Come From?

Next Steps• Federation “Shadow” Board is already up and running

- now need to increase NHS representation

• Consultation ended in Oct.

• FED-IP Prospectus available in October.

• Launch FED-IP Web site with new (simplified)Registration & Membership process in Nov.

• Publish Common Professional Code of Ethics & Standards in Dec.

• Licensing Agreements with Professional Bodies by Dec.

• Launch FED-IP Mar 2015 with a Membership Campaignthroughout 2015

Health Informatics in 2018 -a Re-energised Profession? Gwyn Thomas Predictions Leadership Aspirations.

Documents

inelectronic health

health informatics

health internet

health risks

people healthier

dna testing

patient records

clever use of crude