B. Facing Reality in the Creation 

     of Acute Hospital/Community Electronic Patient Records

 

B00. Overviews (1 Page Each):

2005 Summary of Principles needed for making better use of IT in health care. (As prepared for the then Deputy Chief Medical Officer, Professor Aidan Halligan two weeks before he resigned!)

Halligan.pdf

 

Some Key Words and Concepts relevant to Electronic Patient Records

Words.pdf

 

My personal Experience of the NHS-IT over the past 30 years.  The Berlin Wall between centralised failures; and realistic progress based on local enthusiasm.

BerlinW.pdf

 

The great danger that the current emphasis mainly on collecting data will prove to be as damaging to good patient care as seems to be the case in police

Police overwhelmed by Red Tape

 

What it has often felt like to me Front Line Soldier

B01. Railways Network Rigidity: Not Road System Flexibility! 

(2 pages)

Computers are not magic. They are Flexible in Creation; but Rigid ever afterwards. 

Complex Analysable Electronic Patient Records are always like rigid Railway Networks;  and never like flexible Motorway Systems. 

But scores of invisible and Incompatible Railway Systems are now being created at massive public expense.

          Railways not Roads

 

  B02. The Workload and Cost of EPR Data Entry (16 pages)

On the importance of taking full account of the workload and cost of data entry in the selection of data items for Maternity Electronic Patient Records. The cost of Input and NOT just the value of potential output must dominate the selection of data

Costs

AppendixA

Appendix B & C

  Appendix D

 

B03.  Electronic Records in Maternity Care: 

Coping with Two Unavoidable Hybrids 

           and a Potentially infinite Workload. (9 pages)

Facing reality concerning the complexity of cost-effectively using computers to reduce human error and improve the quality of medical care.  Focusing on the essential need to give priority in the selection of structured data items to  “Individual Patient Care” (especially “Patient Encounter Assistance - iPEA”) rather than “Paralysis by Analysis” data items

Coping with Two unavoidable Hybrids; and a Potentially Infinite workload

 

B04. Destructive Undercurrents (In Preparation)

More detailed exploration of the destructive delusions which have crippled progress in NHS-IT for the past 30 years

DDNeed

 

B05. Essential Steps in the Creation of 

Electronic Patient Record Data Definitions 

           in Acute Hospital Medicine  (5 pages)

Creating EPRs

 

B06. The Mandatory Analysis for all EPR data items (14 pages)

Comments on the kind of mandatory analysis which is essential for every data item which is seriously proposed for inclusion in any Standard EPR National Data Resource Document

Mandatory Analysis

 

B07. Ethical Aspects of the use of hospital I.T. (4 pages)

1990:  Information technology and the White Paper: A Critique

Ethical Aspects

 

B08. Difficult Areas in Perinatal Computing; 

            with some Proposed Solutions (14 pages)

Difficult Areas