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Clinical knowledge architect for hire

Bruce — Wed, 19 Mar 2008 08:34:04 +0000

Dr Bruce McKenzie is now available for freelance consultancy as a clinical knowledge architect, addressing the unmet need for usable knowledge resources at the point-of-care in UK general practice. General practitioners (GPs) make more decisions in a day than a typical business executive, and these decisions cost not just money but potentially lives. It's challenging work, and you can but hope your decisions are based on good information. The problem is information overload and access to what you need when you need it: there's just too much and it's too hard to find in the context of a 10 minute consultation. As a GP for 10 years I can relate to this. I also have informatics knowledge and experience, and this puts me in a position to offer you solutions that are built the way a doctor would design them. The fact is information doesn't become knowledge by itself. After careful needs assessment raw information must be broken down and reconstructed into a usable form as part of a design process that draws upon both the art and science of information architecture. In other words it's a creative process, but it also necessitates solid technical insight into the context in which a knowledge resource will be used. With my primary care background, grasp of medical informatics, passion for writing, and practical experience in delivering concise clinical guidance for use at the point-of-care, I am now available for freelance consultancy as a clinical knowledge architect. Experience in primary care Ten years experience in several general ...

Guidelines: a solution for guideline overload

Bruce — Mon, 21 Jun 2004 11:20:01 +0000

From http://www.bioneural.net :

As previously raised, there are many competing guidelines (NICE, NSF, PCT, etc.) and formularies (Clinical Terms, prescribing) that clinicians must take account of at the point-of-care. Most clinical systems used in British general practice offer templates to prompt data entry and pick-list formularies for prescribing and coding, but these only go so far. How can a practice take account of this competing management advice to streamline and standardize patient care? The answer, somewhat paradoxically, may be to produce another guideline... Why produce an in-house guideline? It promotes a shared standard of care, based on evidence; It can illustrate a role for in-house staff groups (e.g. doctors, nurses, admin) with defined responsibilities; It can converge multiple "competing" guidelines into one ("the best of the best"); It can condense overly complex guidelines for practical use at the point-of-care; It encourages continuity of care (we all follow the same plan); It enables audit against set criteria/ common Clinical Terms; It may improve cost effectiveness (e.g. linkage to a preferred drug formulary, rational lab tests); It should improve clinical outcomes ("best practice"); It could provide documentary evidence for the RCGP QPA; It can help maximise quality point payments under the New GMS Contract; As a guideline cf. protocol, it allows for clinical judgement/ patient preference; It can be useful tool for discussing treatment options with patients. Why use an intranet to publish in-house guidelines? They can be readily updated as the master copy is electronic; This ensures everybody is looking at the same (current) version; The guideline is easily located; It can be cross-linked to other relevant guidelines and documents (e.g. patient ...

NHS IT: the story continues

Bruce — Sun, 02 May 2004 16:00:25 +0000

From http://www.bioneural.net :

From a primary care viewpoint, a summary of NHS IT strategy from Jan 2001 to April 2004, outlining the National Programme for IT (NPfIT) and the implications of the New GMS Contract... What came before? In case you missed it, here is a potted history of IT strategy in the NHS up to December 2000. Building the Information Core (Jan 2001) Building the Information Core: Implementing the NHS Plan was essentially an update to Information for Health (1998) in the light of The NHS Plan (2000), which had some effect on priorities and their delivery dates. It also had to take account of the e-Government Interoperability Framework (e-GIF), all about standards for information interchange in the public sector. The "clarified" targets were: By March 2001: 95% of GP practices and 25% of Trust clinical staff with NHSnet connections and using NHS information services such as the National electronic Library for Health; By March 2002: desktop connections for NHS clinical staff to basic e-mail, browsing and directory services, and roll out of NHS cryptography support services begins By March 2003: migration to national standards for e-mail, browsing and office systems completed and all NHS staff with desktop access, and clinical information systems start to use the SNOMED Clinical Terms; By March 2004: major national payroll/HR systems implemented; By 2005: a vibrant networked NHS, with booking systems in place, electronic transfer of records within primary care, all acute Trusts with level 3 Electronic Patient Records and first generation Electronic Health Records. Delivering 21st Century IT Support for the NHS (Jun 2002) If Building the ...

A history of NHS IT to the Millennium

Bruce — Thu, 29 Apr 2004 16:18:29 +0000

From http://www.bioneural.net :

A potted history of NHS IT strategy up to December 2000, prior to the New GMS contract and the National Programme for IT (NPfIT)... IM&T strategy (1992) The first NHS IT strategy of any significance. The Information Management and Technology (IM&T) Strategy (1992) cited the "lack of integration and commonality" between existing IT systems as a barrier to efficiency and progress. It was to be nationally led but implemented via a Local Action Plan. Key principles of the strategy were: person-based information (linking to an NHS number); systems integration (esp. to reduce duplication of data entry); deriving management information from operational (day-to-day) systems; ensuring security and confidentiality of patient information; information sharing via an NHS-wide network. The strategy also importantly specified the need for: a national thesaurus of coded clinical terms (expansion of the Read Codes); national standards for computer?computer communication e.g. EDIFACT, EDI, X.400, GP system accreditation (RFA). Implementation guidance in the form of a Handbook was produced in 1994. In 1996 the Handbook was updated to take account of other national developments: Developing a Primary Care-led NHS (esp. GP fundholding); Care in the Community; implementing The Health of the Nation; implementing the Patient?s Charter; and the move towards a knowledge-based NHS. Information for health (1998) A product of The new NHS White Paper (see below), a 7-year plan (1998-2005) broadly aiming to "provide the right information wherever it is needed in the NHS, from the doctor?s surgery to any hospital accident and emergency unit. The strategy will also ensure proper information to tackle the causes of ill-health, to plan and monitor ...