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Project Rationale Dr Nick Booth

This project aims to create an integrated clinical record service for the NHS in England, focusing on ethical foundations, patient consent, and clinical engagement. It involves developing educational tools and a simulated commercial product to inform architecture. The enterprise architecture covers organization, resources, functions, and technologies, with characteristics of openness, scalability, and flexibility. Work locations include primary care, hospitals, and out-of-hours services. The project facilitates cultural change, innovation led by clinicians, and local reconfiguration.

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Project Rationale Dr Nick Booth

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  1. Project RationaleDr Nick Booth

  2. Aims of the project • Create a grounded framework for a federated information service for the NHS in England • Create an environment in Durham and Darlington ready to procure an integrated clinical record service by the end of the project in September 2002

  3. Customers of the project • NHS in England (national reference architecture) • Health Community in Durham and Tees Valley Strategic Health Authority area (1.2 million people)

  4. Principles of the project • Ethical and Legal foundation for a shared information service • Based on informed patient consent • Prime inter-organisational clinical information source • Grounding in real clinical work • Engage clinicians in coherent design understanding (using ethnography)

  5. Project themes • Ethical Framework • Security Framework • Ethnography • Educational tools to facilitate user engagement and informing the architecture (ANIMATORS) • Simulated commercial product reflecting the architecture (SIMULATOR) • Governance framework

  6. Enterprise architecture • Projections of enterprise architecture cover: • Organisation • Resources • Functions • Technologies • Governance

  7. Characteristics of the information service • Open • Flexible • Scaleable • Federable • Cope with legacy

  8. Record architecture Terminology Classification Messaging ENV 13606 prENV 13940 Read, SNOMED, Drug dictionary HL7 Framework for other standards

  9. Conceptualising problems in Architecture • Abstraction and Parsimony • Computing science • Exemplification and specificity • Medicine and surgery • To move toward shared understanding we exemplify concepts in animators

  10. Location of work • Primary care • General practice / Multidisciplinary care teams • Transitional care • NHS Direct • Out of hours services • Paramedic /ambulance • Hospitals (Acute services) • A+E ; CCU; Acute medical wards

  11. Context of work • Interdisciplinary Care pathways • Coronary heart disease • National Service framework • Co-ordinated care within and between health care organisations • Cultural issues of trust related to information sharing

  12. From discourse to understanding • Coherence of vision of EHR • System vendors • NHS informaticians, clinicians, managers • Local and national policy • Academics

  13. Facilitate cultural change • Clinically led innovation • Dynamic local reconfiguration • Informatics services as facilitators not leaders of the change process

  14. Technical Animator

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