Unit 5: HEALTH INFORMATICS and HEALTH CONSULTING

The modern discipline of health informatics is still relatively young, and the work carried out by many different groups in this field is not always well co-ordinated. Health informatics can, however, be defined as the study of information and communication systems in healthcare, and focuses particularly on:

• Understanding the fundamental nature of these information and communication systems, and describing the principles which shape them.
• Developing interventions which can improve upon existing information and communication systems.
• Developing methods and principles which allow such interventions to be designed.
• Evaluating the impact of these interventions on the way individuals or organizations work, or on the outcome of the work.

Specific specialities of health informatics include clinical informatics, where the focus is on the use of information in support of patient care, and bioinformatics, which focuses on the use of genomic and other biological information.

Modern healthcare has moved away from seeing disease in isolation, to understanding that illness occurs at a complex system level. Infection is not simply the result of invasion by a pathogenic organism, but the complex interaction of an individual's immune system, nutritional status, environment and genetic structure.

The challenges for healthcare are to put together rational structures for the way clinical evidence is pooled, communicated and applied to routine care, and to develop organisational processes and structures that minimise resources and maximise benefits. The role of health informatics is to develop a system that provides a rational answer to these challenges and its scope is therefore enormous. It finds application in the design of support systems for clinical decisions and administration, in the development of computer tools for research, and in the study of the very essence of medicine - its corpus of knowledge.

A new computer network is going to link up GPs, hospitals and chemists, to improve sharing of patients' records. It will eventually allow patients to look at their own health records from home. Health care records, appointment details, prescription information, and up-to-date research into illnesses and treatment will be accessible to patients and health professionals whenever they need it to make decisions. Access controls will be strict and people will have different views of the record based on their role in the patient's care.

In the past, much essential patient information was written down and filed away. In recent years some information has been kept on computers in an individual organisation but has only been accessible to staff working in that organisation. Now, it will become part of the Records Service - stored securely, but available to the right people when it is needed. It will even be possible to see images of the patient's X-rays and scans. There are other benefits too. Patients will be able to book hospital appointments at a time and place of their choice. Prescriptions may also be sent electronically from the GP to a local chemist.

It is an enormous and very complex task to enable the secure and appropriate sharing of health information of about 50 million individuals. There will be difficulties along the way, but patients, the public and the NHS need to work together to bring about these vital changes.

Patrick has 20 years' experience as a nurse and is a firm believer in the use of technology to support healthcare. He helps to develop the training courses that people need to use new IT systems. A recent taxi ride confirmed his belief that IT is a good thing for the health service. Patrick explains: "The taxi driver was unusually chatty for 6am and asked where I was going at this time on a Monday. I told him I was off to a workshop in London. I told him I worked for the National Health Service and explained briefly about the National IT Programme. He quickly understood that it meant that a patient's details would be available by computer wherever and whenever they were needed.

"That sounds great", he said, "my wife has asthma and every time she goes into hospital they ask for her name and address and stuff and always have to ask her again what tablets she's on. Well, you'd think they'd already know wouldn't you?"

"And another thing," he continued. "You'd think other things would be better organised as well. I'm always being asked to go from one hospital to another to collect X-rays for patients who've been transferred. Sometimes it's a couple of hours before I can get them to a hospital. At the reception desk they tell me to leave them in a tray and they'll get round to them when they've got time. It's the same with specimens and all sorts of stuff. God knows what it costs to use all these taxis; mind you, we give them a special rate."

As we pulled into the station I realised he'd accidentally provided a couple of really good arguments for how the national IT programme is going to improve things. I didn't have the heart to tell him that, special rate or no special rate, his days of ferrying X-rays to and fro were numbered."

Career Opportunities

Health informatics is a broad field covering areas such as electronic medical records, access to knowledge-based information and digital libraries, digital imaging systems, telemedicine, clinical decision support, health policy and decision making, and much more. This provides opportunities for work in various clinical settings, in close contact with a variety of health professional teams and at the hub of information systems and networks within healthcare organisations. The following are some of the areas in which health informatics professionals can find opportunities:

• Hospitals and other healthcare providers.
• Pharmaceutical companies.
• Medical software companies.
• Consulting companies.
• Public health organisations.
• Government and Non-governmental agencies.
• Insurance companies:

One thing that is clear though is that the field of health informatics is now extremely diverse, and the skills and knowledge required vary from job to job. To pursue a career in health informatics you would need not only strong skills in programming languages, but also communication skills, planning and management skills and an understanding of the healthcare industry.

Getting started in health informatics usually requires formal training and a clinical background is an advantage. For people with clinical experience and no IT expertise or those with computer science degrees looking to get into health informatics, some form of postgraduate training in health informatics is probably the best route to follow. There are many academic training programmes available nowadays. These programmes can vary from short courses through to academic programmes that offer degrees at masters and doctorate level. Jobs titles in health informatics vary greatly, and there are a lot of hidden opportunities, so you would have to seek them out actively.

Job description:

HealthSystems is a leading consultancy providing services both within the NHS and with IT suppliers to the NHS. We have a reputation of being a professional, well-informed healthcare informatics consultancy, having worked with more than 60 NHS and supplier clients as well as with healthcare providers in the private sector. We also own a similar successful business in the USA.

Applicants must have:

• An indepth understanding of Healthcare Informatics;
• A minimum of 5 years experience of working with clinical information users either in the NHS or as a supplier;
• Excellent interpersonal and communication skills;
• Strong project management skills;
• An ability to work on your own initiative within a multi-disciplinary team.

We are able to offer suitable applicants the opportunity to become either an employee of the company or appointment as a self-employed associate consultant.