Informing Healthcare

Informing Healthcare is a key part of the Welsh Assembly Government strategy to corporately and collectively modernise health services in Wales over the next ten years.

Informing Healthcare is a project-based strategy. The strategy's aim is to identify individual projects and products and ensure that they are delivered in a coherent way in support of the overall change programme. The Programme does not undertake ongoing information or IT service provision. Such provision will be the domain of national and local health organisations in Wales and, where appropriate, private sector suppliers.

If the project is completed successfully and fully, there will be five benefit areas of Informing Healthcare.

Single Record
Every patient in Wales will have a Single Electronic Health Record. The record will be securely accessible to those who need it when they need it, including the patient themselves. The benefits of the Single Record will be seen directly in healthcare delivery.

The most significant cause of current information problems in the National Health Service (NHS) is the lack of a holistic patient record that is accessible to those who require the information, including patients and carers. Fragments are held by many professionals in many settings but none have access to the whole record. Patients rarely get to see even the fragments of the record. The impact of this is both pervasive and damaging to integrated health and social care.

The concept of the Single Record is designed to overcome these problems. It does not mean that all information will be held in one place, but it does mean that health professionals will be able to access all the information they need, and only the information they need, about a patient whenever and wherever they need it. This access will take place in a secure environment, and profiling of users will ensure that it is limited to what any given professional needs to know.

The eventual goal is the development of a fully integrated approach to health and social care records, although total integration of these records is currently beyond the scope of the IHC strategy.

Workforce Empowerment
All NHS staff in Wales will be given access to a range of new skills allowing them to exploit the full power of new systems. Training opportunities will range from basic IT and information management skills - offered through the ECDL qualification - to more specialist health informatic skills.

It is hoped that the benefits from Workforce Empowerment will be manifold. If the project is carried out successfully, staff will be able to take advantage of new productivity tools, and computerised business support services, to improve their working life. They will be able to communicate much more efficiently through e-mail. The new Human Resources system will provide NHS employees with access to their own staff record. Patients will benefit as staff are able to use automated tools to facilitate patient transfer between clinicians and to provide services such as prescribing which will have in-built safety checks.

Patient and Carer Empowerment
One of the strongly held underlying principles of Informing Healthcare is that patients should be able to play a more active role in decision-making about their health and healthcare. The long-term benefits of shared decision-making would be significant, with far more interest being shown by people in their own health status and in more considered access to health services.

In the short-term, patient satisfaction with services would be increased through the provision of better information about treatments, risks and benefits. Patient anxiety could be reduced significantly if health professionals were able to provide a clearer schedule of the next steps in the care process and the likely duration of the patient journey.

Service Improvement
Service Improvement is about new ways of working, the redesign of healthcare processes, and the use of ICT to support the change.

In recent years, modernisation and ICT programmes in healthcare have not been well integrated. The IHC strategy argues that they must be closely aligned both strategically and in practice if benefits to patients are to be maximised. The introduction of technology without changed working practices has little impact. Changed working practices without new technology is harder to sustain in the long term, and misses important effectiveness and efficiency gains. Most importantly, new technology makes possible new ways of working that could not otherwise succeed.

A range of applications exist which have – properly implemented – been proven to bring benefit in healthcare are early candidates for investment across the NHS in Wales. They include: electronic communications; requesting and reporting of tests; Picture Archiving and Communication Systems ( PACS); and electronic prescribing and scheduling.

Knowledge Management
Knowledge management is concerned with collecting, making best use of and providing access to necessary information while minimising the collection of information that brings little benefit.

In common with many healthcare systems, NHS Wales has a large amount of data but is often unable to use it to good purpose, either at the front-line of care or in support of management and planning. This situation often arises because of a misalignment between the goals of the health service and the measures within it. For example, the goals are mainly about clinical outcome, yet most data collected is administrative in nature. This means that performance management can often seem remote to health professionals.