IT AND TELECOMS
But Creese said it is the way the world is going and clinicians will need to adapt.
He explained: “GPs, like any public service professional, will need to be much more accessible in the future, and keeping email contacts secret for fear that patients will use them seems odd in the modern world.
“We are in an age of technology where social networking and being close to your customers – or citizens – is expected and generally more efficient. Channel shift is part of this, and email, web self-help and administration, such as booking online can reduce, not increase, burdens and costs. And in the future, tele-medicine and home monitoring systems will have a big part to play in health services.
“Clearly you can’t have GPs constantly having to deal with email and bureaucracy, but there are ways and means of dealing with that. Being close to the public and recognised in communities is what all public services should aspire to, and we should be using technology, not resisting it.”
There are serious issues to resolve regard- ing data protection and privacy on the one hand, and transparency and patient access on the other.
Creese comes down firmly on the data- freedom side of the fence, saying: “Transparency will be a high priority in the changes ahead. Local authorities have set a lead in publishing spending, salary, per- formance and other data. In the future, we can expect to see patients in more control of their health records, and the true cost of health provision open to more scrutiny. Assets will be openly documented and performance clearly published. Security controls and privacy matter greatly, but these cannot be used as an excuse to re- main ‘closed’.
“Coupled with this, should be the creation
“The traditional ‘client/supplier’ model is outdated, and simply labelling such arrangements as ‘partnerships’ doesn’t help matters.”
of marketplaces for service outcome and demand-led approaches to health infor- mation systems provisioning that will fa- cilitate personalised choice of health and social care services. This will include the facility to discuss your own records and to see your ‘health account’ – in the way you can see your bank account online.
“This may imply a different relationship between healthcare professionals and the public they serve, but it will, in my view at least, be generally welcomed and more ef- ficient.
“It will, however, require integration of systems, data quality improvement and greater sharing of information securely across local public services. It will also mean a transition from a decade of cen- tral decisions on national IT projects to much more locally-based decisions and autonomy around IT. Gone are the days also of heavy reliance on private sector IT consultants and contractors to deliver change, with internal professionals often not feeling in control of that agenda. IT professionals can now work together with health care and social care professionals to create a new approach.
“This move to localism does not mean that there is not a need for a consistent way of delivering health information and services across the country. It is essential that we have consistency in the way we capture and share information such as patient records and standards for technical infra- structure that allow safe sharing of those records and unified communications. Health records in particular need to be shared across geographic as well as service boundaries and unified communication can save money.
“What is particularly odd is that these sort of problems were solved by the finance sector many years ago, with records easily shared across boundaries of financial institutions and geography, with the necessary security.”
And Creese argues: “In the changes ahead there is a real opportunity for local health services to determine how they wish to bring together the necessary infrastruc- ture and support services as well as profes- sional healthcare, to best meet the needs of an area, working with local government. Whilst these fundamental changes are not easy, the potential efficiency gains are very large and can help to protect resources for frontline delivery.
“We know that trying to prescribe all this from the centre doesn’t work well, because it fails to recognise those local differences and opportunities – existing healthcare provision, buildings, geography, demog- raphy, ethnicity, cultures and the quality of services. It also does not capture local enthusiasm and commitment to change necessary for success. Doing better with less is more likely to be achieved through ‘localism’ – recognising and working with the diversity of local places across the UK – rather than imposing sub-optimal, state- led uniformity.”
Jos Creese is President of Socitm, Chief Information Officer for
Hampshire
County Council and founder of the Local Public Service CIO Council, which he chairs.
Jos Creese FOR MORE INFORMATION
To see the full Socitm response to the Government’s ‘Liberating the NHS: An Information Revolution’ document, visit:
www.socitm.net/downloads/ download/376/
national health executive Mar/Apr 11 | 27
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