The UK Government has proposed to give the private sector unprecedented access to the provision of health care alongside the NHS. It is also intending to give patients access to their medical records online, as well to create new clinical practice data link to provide record-linked, anonymous data about patients to the NHS, to the wider research community and to others. The NHS National Programme for IT is being wound down pending a new information strategy (Spring 2012).
These initiatives raise ethical, profession and technological governance issues. Rather than decrying them, the strategy of the CCSR should be to comment constructively.
The aim of the health informatics thematic group is to form a community of practice employing 3-4 capable research students, who are integrated in to the teaching and research work of the CCSR, while exploring interesting and original ideas as part of their research degrees.
This group will use Responsible Management methods to ensure their work on health care information systems is of a high standard with the purpose of achieving original, significant and rigorous research, suitable for the research excellence framework.
Research students are expected to work on projects that are part of the department’s work on health informatics. Their outputs should be:
- Teaching materials – derived from literature reviews and research results.
- Conference papers – derived from literature reviews and development of methods.
- Journal papers – derived from the results of their research.
Students will be encouraged to develop proposals that are aligned with the set of research questions proposed in the research programme set out earlier.
The essence of the Responsible Management approach to research and teaching will be to ensure:
- Organisational Stability.
Training in research methods is already provided via the Graduate School at DMU but will be supplemented within the CCSR and within the group.
During informal regular meetings and formal fortnightly presentations, the group will work on improving their methods through obtaining systematic feedback, using the Shewhart/Deming PDCA process.
Why Choose Health Informatics?
In the USA, the National Academy of Engineering (NAE) has made “advancing health informatics” a “grand challenge”:
“There is a need,” writes Russ Altman of Stanford University, “to develop methods for representing biological knowledge so that computers can store, manipulate, retrieve, and make inferences about this information in standard ways.”
The CCSR has published a potential solution to part of the NAE grand challenge based on an analysis of the requirements of Responsible Management, which emphasises systematically gathering data from staff and patients about the processes in which they are involved. This also presents an exciting opportunity for the CCSR to lead the way.
Future Projects for Research Students
- How may health care practitioners’ activities and their consequences be represented in information systems? What are the ethical implications of inappropriate representations?
- What requirements does medical research have of health service information systems? And how may they be implemented?
- Who should contribute to and who owns health data? Who is responsible for its accuracy? How should disputes over ‘veracity’ be handled?
- To what extent do all aspects of HSISs, including their security environment, help or hinder health care practitioners in performing their duties and what are the ethical implications?
- How successful would modern software development paradigms such as wikis to define requirements (e.g. the Framework for Integrated Testing) and agile techniques (e.g. Extreme Programming) be in creating designs for HSIS that are sensitive to the socio-technical environment in which the software operates?
- Under which circumstances does knowledge of the processes and outcomes of the activities of health care practitioners encourage management and staff to work together to improve them?
These themes offer the opportunity for local collaborative working not only between faculties in DMU but also with primary and secondary health care institutions through the establishment of research partnerships. Links have already been made with the University Hospitals of Leicester and the Collaboration for Leadership in Applied Health Research and Care - Leicestershire, Northamptonshire and Rutland (LNR-CLAHRC). Future opportunities in the area of clinical process description could also be developed internationally, for example with the Technische Universität Wien, which has similar interests.
These will be kept under review and modified as the group develops. Research students should be aware that proposals covering other topic areas will also be considered and accepted if the thematic group is able to undertake supervision.
CCSR will seek to maintain a stable team of 3-4 research students to work on health informatics projects.
Students seeking research degrees could be funded through DMU scholarships, alumni scholarships and bursaries. These are relatively rarely awarded so in the longer term, the aim will be to fund these posts through thematic group research grants. Future grant applications will seek to obtain research funding sufficient for the post-graduate students as well as for relevant members of staff.
New Courses and Modules
The group will be expected to collaborate with others in the Faculty of Technology and the Faculty of Health and Life Sciences to develop a programme of study in health informatics, which might be targeted at undergraduate students, but more likely postgraduates and personnel working within the NHS or within international health care institutions.
This course would seek to develop an understanding of how information technology could assist clinicians and management in their work, by gathering real-time data which supports the continuous improvement of processes. Responsible Management is becoming increasingly important in health care as a result not only of litigation but of having to balance the demand created by offering a wider range of interventions to a growing population with longer survival against competing financial pressures.
The research students should during the course of their work be able to provide extensive teaching material which may be used both to support the proposed new course as well modules for undergraduate and post-graduate students.