The Birth of UK chip

1. The Birth of UKchip Helen Sampson • Treasurer, UK Council for Health Informatics Professions • Clinical Guidelines Manager, Royal West Sussex NHS Trust • Chair,British Computer Society Health Informatics Nursing Specialist Group • Chair, Nursing Professions Information Group

2. Developing Health Informatics Professionalism • Glyn Hayes BCS HIC • Di Millen NHSIA • Tony Eardley ASSIST • Alan Gillies Univ Central Lancashire • Helen Sampson Royal West Sussex Trust • Bruce Madge National Patient Safety Agency • Mik Horswell IHM • Chris Taylor Univ Manchester

3. The Problem • The need for a career pathway • The need for adequate recognition • Professional Credibility • Appropriate Remuneration • Correct Workplace Setting • The need for a professional “home” • Current organisations do not meet these needs

4. Bad Health Informatics Damages Patients • Patients must have died due to the London Ambulance system failure. (Parliamentary report) • Abnormal cervical smears not acted on until too late • Incorrect radiotherapy doses • Downs Syndrome risks inaccurately reported

5. 1. Incidents reported in 2002 • Hospital forced to revert to manual systems after 3 days of repeated crashes • Hospital requested pensioner needing eye test to bring his parents to appointment • Computer problems resulted in unreliable findings on reported medical errors • Baby girl died of meningitis after being misdiagnosed by NHS Direct • Patient asked about non-existent pregnancy • GP practice telephoned a relative to cancel an appointment for a dead patient • Elderly men informed their pregnancies had led to postponement of their operations

6. 2. Incidents Reported in 2001 • Replacement hospital system unable to provide previously available information • Incorrectly matched kidney removed after transplant failed • Malicious software infection affected Radiology PACS • Disruption of e-mail service on NHSnet • Numerous incidents involving computers and blood transfusions • Inadequate NHS information systems in context of Bristol Inquiry • Hospital telephone and pathology systems severely disrupted by fire

7. 3. Incidents reported in 2000 • Seattle Hospital Hacked - 4000 records downloaded • Ambulance computers blamed for delays in answering 999 calls • Caesarean section by torchlight following UPS computer failure • Numerous incidents involving computers and blood transfusions • Software changed following prescribing error that contributed to patient's death • Computer virus forced shutdown of most systems at London teaching hospital • Millennium Bug led to incorrect results for Downs Syndrome tests • Cervical screening failures may have lead to deaths of nine women • Power line fire disrupted telephone links to city hospitals

8. 4. Incidents reported in 1999 • Computer overridden during incompatible transfusion • women wrongly informed of multiple sexual infections

9. 5. Incidents reported in 1998 • Medical records error resulted in a healthy Spanish pregnant woman having her ovaries and uterus removed • Numerous incidents involving computers and blood transfusions • Different blood bags labelled with same identification number

10. 6. Incidents reported in 1997 or earlier • Computer system contributed to death of meningitis patient • Programming error caused cancer patients to receive the wrong doses of radiation • Casual data entry workers employed to enter confidential patient data • Confidential patient data lost or sent to wrong hospitals • Medical Equipment in Cardiac Laboratory failed to recognize Leap Year • London Ambulance Service - failure of Computer-Aided Dispatch system led to fatalities • Software errors in therapy system resulted in six accidents including three deaths

11. The Real Problem • Patients are being damaged by bad health informatics • Patient care is increasingly impacted by informatics

12. What is a Professional Body?Lord Benson 1992 • Controlled by governing body which directs behaviour • Sets entry standards and professional competence • Sets ethical rules and professional standards • Body is designed for benefit of public & not members • Work often reserved by statute • Ensures fair and open competition • Members must be independent in thought and outlook • Gives leadership in a field of learning

13. Key Elements of a Professional Body • Setting entry education and training standards • Ensuring continuing professional competence of members • For the benefit and protection of the public • Leadership in a field of learning

14. Pay & Rations Trade Union Members Needs Education Research Qualifications British Medical Association Royal Colleges Medical Schools General Medical Council Professional Control Patients Needs The Medical Model of Professionalism

15. The First Steps • The NHSIA recognised the problem • A steering group was formed; • NHSIA • BCS • ASSIST • UKIHI • IHM

16. Pathways Discussion Document • What is Health Informatics • “The knowledge, skills and tools which enable information to be collected, managed, used and shared to support the delivery of healthcare and promote health” • Who should be included • Medical records, Coding, Audit • Libraries and knowledge management • Information systems dev and support • Information and communications technology • Help desk, Data analysts • Clinical/medical informaticians

17. Embracing All • “The breadth of the discipline offer particular challenges. Any solution or pathway to the establishment of health informatics as a recognised and respected national profession must in inclusive (not exclusive) and serve the needs and aspirations of all working within the profession, whatever their background or level of qualification”

18. Working with not against • The health informatics professional community is currently fragmented   • Collaboration must, however, also allow for individual professional bodies and groups to retain their identity

19. Meeting NHS needs but also.. • If the national modernisation agenda is to realise its objectives, the Service requires sufficient skilled, knowledgeable, proactive specialists in all areas of health informatics • Must be UK wide and healthcare wide

20. Options • Do nothing • Apply for Statutory Regulation now • Agree to work incrementally towards voluntary regulation

21. Pathways Conference • Keynote Presentations • Dr Peter Griffiths, Vice President, Institute of Physics and Engineering in Medicine • Dr Nikki Shaw – a young career health informatician

22. How do we make this inclusive and who should be included? • All clinical and information professions must be included • We need managers who will encourage membership • The correct balance between inclusive entry and rigorous accreditation is essential • A grandfather entry

23. What are the barriers and risks? • Lack of commitment from senior management • Bringing people with varying backgrounds into one professional body,with the risk of elitism emerging • Professional accountability requiring a significant cultural change and leading to massive exposure to liability

24. What would make this attractive to you? • “The recognition that comes from professional standards and clear career pathways”

25. UK Council • Over 50 Movers and Shakers invited • Personal invitations not representatives • First Meeting 23rd September • Working Groups Established • Professional Standards WG   • Legal and organisational WG   • Finance and resources WG    • External Relationships and Communications WG  • Registration WG • Web Site established

26. Inclusive • Full Time Informatics Professionals • “Hybrid” Informatics Professionals • NOT end users

27. UKchip’s formal Aim • Its aim is: • “to be the regulatory body for all branches of health informatics in the United Kingdom”

28. UKchip Objectives • a)      To promote, advance and encourage the study and practice of the application of Informatics in the promotion of health, well being and dying with dignity • b)      To establish, uphold and improve the standards of qualification, training, competence and conduct of Health Informaticians in the United Kingdom

29. UKchip Objectives • c)      To establish mechanisms for the benefit and protection of the public • d)      To collaborate with official bodies, societies and professional associations on matters relating to the above

30. Timetable • Sep 02 Form the Council and agree a more detailed plan • Jan 03 Open a register of individual expressions of interest • Jul 03 Publish draft professional standards for consultation • Sep 03 Finalise initial version of standards • Oct 03 Open a voluntary register of HI professionals

31. Progress so far • Charitable company limited by guarantee • 850 Expressions of Interest • Definition of Constituencies to cater for various disciplines • Initial work on CPD schemes

32. What to expect • Defined standards for HI professionals • Defined behaviour for HI professionals • Recognised CPD schemes • Registration to provide recognition for HI professionals • De registration to protect patients

33. Useful Contacts • www.ukchip.org

34. Questions