Project Rationale Dr Nick Booth

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Project RationaleDr Nick Booth

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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

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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)

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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)

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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

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Enterprise architecture

• Projections of enterprise architecture cover
• Organisation
• Resources
• Functions
• Technologies
• Governance

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Characteristics of the information service

• Open
• Flexible
• Scaleable
• Federable
• Cope with legacy

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Framework for other standards

• Record architecture
• Terminology
• Classification
• Messaging

• ENV 13606
• prENV 13940
• Read, SNOMED, Drug dictionary
• HL7

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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

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Location of work

• Primary care
• General practice / Multidisciplinary care teams
• Transitional care
• NHS Direct
• Out of hours services
• Paramedic /ambulance
• Hospitals (Acute services)
• AE CCU Acute medical wards

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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

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From discourse to understanding

• Coherence of vision of EHR
• System vendors
• NHS informaticians, clinicians, managers
• Local and national policy
• Academics

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Facilitate cultural change

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

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Technical Animator