Professionalism in a changing Health

environmentJean Roberts

BCS Health Informatics Forum Policy lead

Jean@hcjean.demon.co.uk

Challenging factors

• Technology• Organisation• Professional• Patient and client• Public• Funding

DEFINITIONSHI is the knowledge, skills and tools which enable information to be collected, managed, used and shared to support the delivery of healthcare and to promote health.

Health informatics is concerned with the systematic processing of data, information and knowledge in medicine and healthcare. The domain covers computational and informational aspects of processes and structures, applicableto any clinical or managerial discipline within the health sector whether on a tele (remote) basis or not. Health informatics is delivered by operational health practitioners, academic researchers and educators, scientists and technologistsin operational, commercial and academic domains

HI is study of the nature and principles of information and its applications

within all aspects of healthcare delivery and promotion

To represent all this activity is a challenge

The PatientThe Patient133 People to take care133 People to take careof the patientof the patient

“If I wanted to go there I would not have started from here”

Audiogram

Analysis of the voice EEG, MEG., RMN.

Breath: volume, pressure, VO2, VCO2…...

Vascular blood flowDoppler Ultra Sound

ECG, EMG, BSM

Breath: Frequency, Amplitude, Flow,...

Skin: Temperature, Resistance,Impedance, Blood FlowHydratation, color,…Thermic & tactile sensitivity

Cardiac frequency & foetal movement

Forms of the body & dimensions(Optic, laser, Ultra sound, X-Ray)

Pulmonary sound Cardiac sound

Muscular sound

Arterial pressure

Emotional responseVigilance, Mental charge

EMG signal processingActivity of muscles:movement, speed, power

Urinal flow

Not so much ‘In the future’ now!

1998 Information for Health

2002 Delivering 21st Century IT

2002 Wanless (funding)

2003 Wanless II (Public Health)

2000 NHS Plan : a plan for investment and plan for Reform

1997 The New NHS : Modern, Dependable

Protti evaluations

Readiness Reviews

NPfIT communications

Patient data may come from anywhere

• Visits the dentist / therapist ...

• Has home visit from GP, nurse, care worker, midwife …

• Visits a Walk-in Centre

• Calls OOH service

• Uses a Home Healthcare Guide

• Calls NHS Direct or NHS Direct Online

• Visits OP

• Attends A&E

• Visits GP / Practice nurse

• Goes to pharmacy / self-medicates

• Attends as IP and has interventions ….

Fudge or fiddle?

Ethics of a professionalcheck out www.ukchip.org.uk

• development of a strong Code (of Ethics / Conduct)

• establishment of standards of professionalism that will set you ‘apart from the crowd’

• provision of information for organisations and employers by ethics experts in HI

• circulation of case studies and other information to keep the importance of ethical conduct highly visible to all members of the profession and the public

WATCH OUT for HI Week in May

Informatics in the Health domain

• FOCUS : Diagnosis, care and treatment• HISTORY : Computing since early 60s• LOCATION : Disparate and isolated• POSITION : Non-mainstream service• IDENTITY : Caricature only• INTEGRATION : minimal

Definition of a Professional Body

• 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

ref : Lord Benson 1992

UKCHIP launch - 10.03.2004

Synergy & subsidiarity

• The health informatics professional community is currently fragmented and covers a wide range of competencies

• Collaboration must, however, also allow for individual professional bodies and groups to retain their identity and activity

Challenges• Include ALL clinical and ‘informatics’

professions• Engage managers to encourage membership,

stimulate professional development …• Strike the essential correct balance between

inclusive entry and rigorous accreditation • Cope with existing critical mass by a

grandparent entry scheme• Establish processes complementary to other

organisations• Look forward and outward consistently

Progress so far• Corporate establishment as Charitable

company limited by guarantee• 1100 Registrations in or through

pipeline• Standards, Code of Conduct, website,

on-line Registration scheme, Continuing Professional Development examples accruing

• Formal launch (March 04)• Recognition from many quarters

UKCHIP Registration : COMPONENTS

• Academic

• Job Role

• Years in Health

• Years in Informatics

UKCHIP LEVEL

ACADEMIC• Level 1 - N(V)Q 2 …… 5+ GCSEs• Level 2 - N(V)Q 3 …… 2+ A levels• Level 3 - N(V)Q 4 …… HNC, first

Degree, or higher

• but that only takes you so far, how do you prove you can operate safely in the real world?

JOB ROLE• BCS Industry Structure Model ( and Skills

for the Information Age specification)– autonomy, responsibility and authority– influence– job complexity– personal skills

• mapping to DH Job Evaluation Handbook, Knowledge & Skills Framework and National Occupational Standards

VOCATIONAL COMPONENT -

– 1.5 (Level1)– 3 (Level 2)– 6 (Level 3)– concurrent or sequential

In health In informatics

Stages to go• Count down the Health Professions

Council membership• Recruit and retain registrants• Formalise Council elections and

business practices• Transition entry and re-registration

processes to long term versions• Map synergistic qualifications, CPD,

roles ..

Why bother?

• Profession is maturing

• Standards will be set and the barre is raising

• Licence to practice will become mandatory

• UKCHIP has increasingly recognisable cache

• Personal development well-defined and visible

Information sources

• www.bcshic.org• www.bcs.org/forums• www.ukchip.org.uk

• jean@hcjean.demon.co.uk

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

• 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