ROUND-UP SHEILA BULLAS - British Computer Society SHEILA BULLAS In this issue we celebrate the UK involvement at the worldwide nursing informatics conference, NI2009. There was a strong

R O U N D - U P S H E I L A B U L L A S

In this issue we celebrate the UK involvement at the worldwide nursinginformatics conference, NI2009. Therewas a strong UK presence to show theworld the excellent work being undertakenhere. An impressive line-up report in thisissue: Brian Layzell, Heather Strachan,Kathy Dallest, Gillian Flett, Anny Casey,

Dawn Dowding, Peter Murray and CarolBond. BCS is always pleased to supportits members who have their work acceptedfor presentation at this and similar events.In my view the topics discussed show thematurity that nursing informatics aroundthe world has achieved.

Closer to home, Phil Paterson, ASSISTNational Events Co-ordinator, reports onthe ASSIST national conference. Morethan 200 delegates heard keynotepresentations from Christine Connelly andTim Straughan and participated ininteractive workshops.

A subject dear to my heart is theannual conference of the HealthInformatics Forum: better known as HCor the Harrogate Conference. Building onthe programme of change that has been inprogress over the past two years and onthe success of HC2009, the event ismoving to Birmingham’s InternationalConference Centre in 2010. The dates foryour diary are 27- 29 April. The change

Changes are afoot

HINOW September 200902

continues, now under the chairmanship ofMike Sinclair. I encourage all those thathave supported HC in the past and thosethat are new to health informatics andhave not attended before to take a closelook: it is your event and will succeed onlywith your enthusiastic involvement. Thereis a lot in it for you: hearing the latestfrom leading lights in health informatics,presenting your work, learning what othersare doing, presenting your products andservices and networking. If you would liketo make your views known through thispublication, we will be delighted to receivethem and ensure they are pass ed on to theconference organising group.

HINOW provides an opportunity foryou to exchange views or present yourwork. You might feel moved to submit anarticle or write to the editor. We are keento hear from you. What do you find mostinteresting about HINOW and what wouldyou like to see in future issues? Let usknow at [email protected]

Sheila Bullas, editorial board leader, HINOW; secretary, BCS Health Informatics Forum; director, iBECK.

03September 2009 HINOW

06 Sensory enhanced health information systems

The related concepts of consumer oriented and driven healthcare services, and the increasing relevance of home and mobile monitoring devices to improve personal independent living were discussed throughout the NI2009 programme.

08 Personal health information management systems

The topic of the NI2009 post conference was Personal Health Information Management Systems (PHIMS): Tools and Strategies for Citizen’s Engagement (in their health care).

10 Human computer interaction

The human computer interaction stream at the recent Nursing Informatics conference (NI2009) included a look at the online managed knowledge network that shares knowledge in eHealth in Scotland.

12 Outcome measures and ethical competence

The human computer interaction and ethics and nursing informatics streams at NI2009 provided delegates with a new set of challenges.

14 Pre registration educationCarol Bond provides an overview of the pre registration education stream that ran through NI2009.

15 Educational informatics

A discussion based around five presentations covering educational aspects of health and nursing infomatics.

18 Evidence based practice

A report on the strand of the NI2009 conference that focused on different ways of providing evidence to clinicians to help them make decisions at the point of nursing care.

Member and specialist groups

16 BCS ASSIST 2009 conference report

Overwhelmingly positive feedback was received from delegates regarding the 2009 ASSIST National Conference,which featured a number of key speakers and a wide rangeof workshops.

+ 4 Industry news 19 Events diary

HEALTH INFORMATICS NOW

is the newsletter of The British Computer

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H I N O W C O N T E N T S


Edinburgh invests

£1m in telecare

Edinburgh City Council is to spendapproximately £1m on telecare thisyear, doubling the amount it hasspent in previous years. The moneywill enable the installation of morethan 1,000 new complex telecarepackages, technological upgradesand more telecare support to disability groups.

This will mean 1,500 peoplewill be supported to live in theirown homes and 700 carers will besupported in caring for relativesusing telecare systems. Theprogramme is estimated to save3,000 hospital bed days and 3,000care home days per year.

Trust tracks and

recovers stolen laptop

Lancashire Care NHS FoundationTrust has been able to track downand recover five stolen laptopsafter installing Computrace on theTrust’s equipment.

The trust implementedComputrace from AbsoluteSoftware across its whole IT estatethree years ago. Since then it hasrecovered five laptops stolen inseparate incidents. As part of theComputrace service, the companyprovides a dedicated theft recoveryteam who physically retrieve thelost or stolen computers when theyare allocated.

VoIP in Nottinghamshire

Nottinghamshire Healthcare NHSTrust has announced that it hascompleted the implementation of aVoice over Internet Protocol(VoIP) platform from ProximityCommunications.

Staff can now quickly identifywho is working where, call handlingis automated and maintenance ishandled at a central location, all ofwhich helps to reduce costs andimprove service delivery.

I N D U S T R Y N E W S

Hospital comparison sitesPatients can now compare hospitals basedon indicators, from car parking to mortality rates, following the launch of anew comparison element on the NHSChoices website (www.nhs.uk) by theDepartment of Health. Working in a similar way to other internet comparisonwebsites this enables patients to use ascore card to compare several differenthospitals on a range of indicators.

Hospitals can also be rated on keymeasures, including cleanliness, waitingtimes and MRSA infection rates and thesite also allows patients to compareclinical performance.

The Department of Health will alsolaunch a similar service to allow patientsto rate and compare GP practices, towardsthe end of the year.

‘Right records for the right patient’, asystem to make it easier for clinicians toidentify the correct health records for theright patient is due to be pi loted byInforming Healthcare next year.

The Enterprise Master Patient Index(EMPI) will help organisations keeppatient data such as name and address up-to-date and accurate. This will makesearching for patients’ health recordsfaster and safer. The EMPI will beparticularly beneficial for clinicians usingthe Welsh Clinical Portal.

The EMPI will work by linking all therecords for an individual patient heldacross several information systems to asingle ‘gold standard’ patient identityrecord. It will then ensure that any newpatient registration or changes of nameand address are recorded once and copiedacross to all the sys tems that need toknow about them.

Key aims of the index are to:

improve patient safety; support mergers and the creation of new NHS Wales health boards;support the implementation of the Welsh Clinical Portal.

BCS has signalled a new era for itsrenowned annual health informatics eventby moving it to Birmingham in 2010.HC2010, the Health Informatics Congress,will be held at the city’s InternationalConference Centre (ICC), from 27-29 April.

The ICC was chosen because its centrallocation and facilities are able to supportBCS’ long-term ambitions and plans forthe event, says Mike Sinclair, the new chairof the event’s organising committee.

He says: ‘Health informaticsprofessionals have an increasinglysignificant influence on the shape, directionand ongoing operation of services across

Tories promise changeThe Conservative party pledged to abolishthe NHS national database of electronicpatient records following the publicationof the ‘Independent Review of NHS andSocial Care IT’. However, they went on tosay that firms such as Google andMicrosoft would be allowed to host patientcontrolled records accessed online.

The party have promised to renegotiatethe contracts Labour signed for IT serviceproviders to prevent future inefficiencies.

This commitment raises the prospect ofpotential new government becomingembroiled in legal disputes with BT andCSC, the two main IT firms that hold localservice provider (LSP) contracts. In factthe Labour government has been locked in

September 2009 HINOW 05

health and social care. This event providesa unique and powerful opportunity tobring professionals from across the UKtogether under one roof to learn anddiscuss key issues.

‘Now, more than ever, it is vital forthis community of professionals to gettogether to debate future directions andmake connections.

‘We want HC2010 in Birmingham tobe an integral part of life for the manyhealth informatics professionals in the UK- a “must-attend” event for those eithersetting the agenda or having to deliveragainst it.’

legal dispute with Fujitsu since terminatingits LSP contract in April 2008.

The Conservatives accuse the NHSNational Programme for IT of beingoverly bureaucratic and responsible forspiralling costs and huge disruptions tothe NHS. Their intention is to reform thesystem and focus on allowing Trusts tohave a local choice of system, which theysay will deliver significant cost savings.

Dr Glyn Hayes, chair of the review,said: ‘The review makes clear that NHSIT will only succeed in improving patientcare if information is held locally andcentred on the patient.’http://media.ft.com/cms/bfdf9c1e-85b3-

11de-98de-00144feabdc0.pdf

They’ve got mail

Cwm Taf, North East Wales andHealth Solutions Wales are the firstthree NHS Wales organisations tocomplete the move to a new securenational active directory and emailservice (known as NADEX).

The national directory serviceallows users to log on to sys tems andservices regardless of where theyaccess a computer, while a nationalemail service provides a single up-to-date address book and allowshealth professionals to share diarieswith colleagues across organisationswithin NHS Wales.

All NHS Wales organisations aredue to move to NADEX by the endof the 2009/2010 financial year.Pilots are due to take place in Northand South Wales during 2010.

Just three numbers

NHS Direct recently commented onthe consultation for a new nationalthree-digit number to access urgentcare. Nick Chapman, Chief Executiveof NHS Direct, said:

‘The memorable three-digitnumber seems likely to offerimproved ease of access to care andadvice over the telephone for patientsand the public. NHS Direct islooking forward to working closelywith the Department of Health andthe rest of the NHS to d evelop this.’

He went on to say ‘NHS Directwill be supporting the proposedpilots of the new number, as andwhen these are agreed.’

New health informatics MSc

A new Masters programme in Health Informatics is being offeredby YCHI at the University of Leeds’Institute of Health Sciences. Thecourse has been developed in conjunction with NHS and industry partners.

The course, which is practical andvocational, prepares students for acareer in health informatics and isaimed at new graduates, informaticsprofessionals and those who wish toconvert their skills for use within ahealth care setting. Study can beundertaken over one year full-time orthree years part-time.www.ychi.leeds.ac.uk/msc

BCS moves to Birmingham

World class commissioningAs part of its ongoing commissioning programme, the NHS is providing datapacks on behalf of the Depar tment ofHealth to support commissioners throughout the commissioning cycle, andalso during the World ClassCommissioning (WCC) assurance process.

This online resource brings togetherdata from multiple sources to provide aprofile of each organisation withbenchmarking against national averagesto help monitor trends and makecomparisons.

The NHS has worked with PCTs andSHAs to improve and refresh the content

and also the technical functionality tooffer a more interactive product.

Covering some 250 indicators, the2009/10 data packs are designed to helpPCTs prepare for the second round of theWCC panel assessments in early 2010.

The data is regularly refreshed,providing an essential resource forcommissioners throughout the wholecommissioning cycle.

To find out more go to:www.wave.ic.nhs.uk/Services/

or you can register for the data packsand receive an alert if you visit:www.ic.nhs.uk/commissioning


Beginning with an overview of thepopulation demographics showing that anincreasing ageing population will have tobe supported by a decreasing workingpopulation, with dependency ratios shiftingfrom 9:1 (world), 5:1 (EU) currently, to4: 1 world, 2:1 (EU) by 2050, theyadvocated an increasing use of ‘HealthEnabling Technologies’ (HETs) forcreating sustainable conditions for self-sufficient and self-determined lifestyles,along with sensor enhanced HETs having

a major role in enabling ambient assistedliving. Such devices would graduallybecome cheaper, smaller, more portable,even wearable. They described some sensordevices being as small as a one Eur o coin!

This led naturally into a description ofthe parallel concept of the ‘smart home’and the ‘home hospital’ – using sensorsinstalled in the building to monitoractivity/movement and vital signs, as wellas providing alarm/alert facilities and themeans for the individual to control local

Starting with the opening keynote lecture,a double header from Reinhold Haux andMichael Marschollek (Peter L. ReichertzInstitute for Medical Informatics,University of Braunschweig Institute ofTechnology and Hannover Medical School,Germany) on ‘Sensor-Enhanced HealthInformation Systems for Ambient AssistedLiving: New Opportunities for Nursing’discussing consumer orientated and drivenhealthcare services which were decidedlyin vogue at this year’s conference.

Sensory enhanced HI systems

N I 2 0 0 9 R E P O R T

The related concepts of consumer oriented and driven healthcare services, and the increasing

relevance and sophistication of home and mobile monitoring devices to improve personal

independent living were given a thorough airing throughout the NI2009 programme. Consulting

Informatician, Brian Layzell, reports.


setting to make the house ‘work’ for them, which will surely become morecommonplace during the next few decades.

Professor Haux concluded by layingdown a challenge to the nursingprofessions to the effect that it would betheir responsibility to help ensure thatHETs became an integral part ofmainstream care provision.

The concept of the ‘medical home’ or‘home hospital’, was also addressed byProfessor David Bates (Chief, Division ofGeneral Medicine, Brigham & Women’sHospital, USA) in his keynote lecture‘Improving Patient Safety Using IT’. He argued that since people generally are willing to use portable devices, forexample, mobile phones etc, they will alsoaccept and even demand access to healthinformation (personal health records) viamobile devices as well as expecting theirhealth services to provide home andmobile monitoring. There is plenty ofscope for widespread introduction of suchfacilities but he cautioned that suchdevelopments would have to conform tothe rigours on standards, e.g.interoperability for data exchanges. Itwould, he said, be important to get thetechnologies and the standards right.

These two keynotes were particularlyapposite since they provided a curtainlifter to several other presentations onsimilar topics, including my own (‘TheElderly Demographic Timebomb – Sharingthe Load with the Ac tive Ageing: CaneHealth Technologies Help Defuse It?’).Other papers addressed, inter alia,research being undertaken to present alaboratory prototype home carearchitecture that integrates data fromdifferent sources and uses a decisionsupport system based on the HL7standard Arden Syntax for MedicalLogical Modules, and innovations inpersonal health record design, coupledwith home monitoring via sensors located in ordinary domestic items, and also explored the use of socialnetworking services.

These presentations addressed theconcepts of using sensors and monitoringto provide support to individual people aspatients (in managing their care andtreatment) but also for the ‘ageing well’population, who want to subscribe tomonitoring services to maintain theirhealth and lifestyles as part of their ownpreventative medicine regimes, whichwould have economic benefits.

The topic of ‘patient empowerment’

linked to that of telecare was wellrepresented, with some 15 papers, 17posters, one workshop, one scientificdemonstration and one panel discussion.The most common elements of contentbeing, the use of online consumersurveys/questionnaires; access to web-based health information; web-basedpersonal health records; telecare and tele-monitoring; the legal and socio-cultural implications of, for example,remote monitoring of people. Thisarticulation of the growing prevalence ofweb-based services, and the apparentrecognition that, when used properly – i.e.in conjunction with professional (physical)intervention - was encouraging, as was theevidence of consumer acceptance of, andsatisfaction with, these facilities.

Equally, it was good to hear aboutexamples of people being involved inconsultative processes to design new web-based information services as part ofNational Health Service policies, as wellas on an individual care basis. This seemedto emphasise the shift towards recognitionof consumer driven healthcare provision.

A significant message that camethrough was that of ‘listening to theperson’ – in various ways, severalpresentations stressed the importance ofthe patient’s own narrative in building anaccurate record and thus ensuring betterdiagnosis etc. The vehicles for doing thismight be: online, web-basedquestionnaires, or free text (structuredand unstructured) input to a personalhealth record, which could be importedinto an electronic health record, the hopebeing that attending health professionalswill read it and use it.

In the final keynote lecture, Dr JacobHofdijk (President, European Federationfor Medical Informatics and SpecialAdvisor to the Ministry of Health, TheNetherlands) concluded with a plea totake any opportunity to do more to breakdown the ‘silo mentality’ in health servicedelivery, to embrace the practices ofsharing information between professionals,organisations and individuals. Now, wherehave we heard that before!?

He warned that with instances ofchronic disease on the increase, coupledwith the changing populationdemographics, there was now an urgencyto put more emphasis on home and mobi lemonitoring as well as promoting goodhealth, with better definitions, for example,care standards, which should be focusedon providers, professionals and consumers.

For me, perhaps the single mostsignificant and encouraging concept tocome out of NI2009 was this: the thread(consensus) running through theprogramme - keynote lectures andpresentations, together with posters,workshops and panel discussions, and ofcourse the informal discussions outside ofthe sessions – that patients are people andshould be treated not as ‘patients’ but asclients or consumers of health careservices. Clearly the right way to go.

N O T E S O N N I 2 0 0 9

Nursing Informatics 2009 is the 10th such congress following previous successful congresses held inLondon (1982), Calgary (1985),Dublin (1988), Melbourne (1991),San Antonio, Texas (1994),Stockholm (1997), Auckland (2000)and Seoul (2006).

This year’s congress wasorganised by the IMIA-SIG-NI incollaboration with the Finnish Nurses Association.

Participants of the event, whetherthey were presenters, tutorial leaders,panel members, students or just run-of-the-mill attendees, wereencouraged to share their informaticsexperiences with their colleagues.

Those attending included a widerange of health informaticsprofessionals, including:

nurses;nurse informaticians;nursing and informatics educators;nurse managers and executives;nurse and informatics researchers;other health care and IT professionals.

The central themes for discussion during the 10th Congress were:

health and humans in support of nursing informatics practice; management education and research.

These were seen to be consistent withthe overall theme of nursing informatics. The congress was held atthe Helsinki Exhibition andConvention Centre, Finland between28 June and 1 July 2009.


Each attendee gave an overview of theircountry’s PHIMS status.

Overall summary Personal health information managementsystems (PHIMS) have emerged out ofpersonal health records. Functions include:the ability to access and record healthevents; access to information about health,disease, treatment and services; access toservices and communication changes.

There are three models of PHIMS,including stand alone, tethered andintegrated. The latter are on a continuumwith the tethered, receiving informationfrom more than one provider. Tethered is

seen as the most beneficial to bothhealthcare provider and the person, and itis potentially possible to implementwhatever health system is in operation.

Most countries do not have data onhow many citizens use a PHIMS due tothe different models of systems available.The USA has assessed this and the statsare 9 per cent of citizens have a PHIMSand 42 per cent believe it is a good idea.Finland is potentially the most advancedcountry with some aspects of PHIMS innational use.

Most countries have recognised theneed for specific infrastructurerequirements including unique identifiers,secure networks, interoperabilitystandards, clinical data standards andaccreditation of health systems.

Additionally, most countries appear tohave subtle differences in their laws withregards to ownership and the control overrecords but in reality there appears to bea partnership approach to implementationthat is pragmatic. Some risks appear toexist, i.e. legal status of stand alonePHIMS where a third party is guardian of data.

AustraliaA key vision of the nation Health andHospitals Reform Commission is that ‘by2012 every Australian should be able tohave a personal health record that isowned and controlled by the individual,including designating health care providersthat can access the record and d eterminewhen and how the personal health recordis stored, backed up and retrieved.’

To support this vision the government’sNational eHealth Transition Authority areworking towards the deliver of a privacyblueprint, standards for secure messaging,interoperability, clinical data standards,unique patient and provider identifiers andauthentication regimes.

BrazilProvider electronic health records (EHR)are emerging and there are several versions. However there is no policy to

The post conference was organised intosix topic areas including:

usability questions: specifying user requirements for PHIMS 3;technology: technical and infrastructurerequirements for PHIMS;practice: integrating PHIMS into clinical practice: guides for nurses;consumers: PHIMS - confidentiality and Safety;governance: PHIMS - policies that foster adoption and use;education: PHIMS and education: preparing nurses to practice in a wired world.

Personal health informationmanagement systems

N I 2 0 0 9 R E P O R T

The topic of the NI2009 post conference was Personal Health

Information Management Systems (PHIMS): Tools and Strategies

for Citizen’s Engagement (in their health care). Heather Strachan

reports on this section of the conference.


develop national PHIMS in Brazil. It isworth noting that Brazilian law meansthat the patient owns their health recordand the provider has the right to keep itand the technical responsibility is given tothe institution. Some infrastructure isbeing developed to include the RUTE network, which integrates around 57health care institutions.

FinlandFinland’s eHealth Road Map was developed in response to the EU’s eHealthAction Plan. Its aim is ‘to secure theaccess to information for those involved incare regardless of time or place in boththe public and private sectors.’ There area number of key projects underway includ-ing the National Archive for PersonalHealth Data, which patients can access to supervise its use. The National SAINIproject provides electronic services for allcitizens and there is also a national citizen’s health information portal.

South Korea Current PHIMS in Korea are run by different organisations including government, private and healthcare sectors. They are either web-based servic-es or ‘tethered’ to a hospital record. Theyprovide a range of functions includingaccess to information, services and communication channels.

New ZealandThere is currently no National PHIMS.Provider EHRs are available and the aimnationally is to support communicationand connectivity via a distributed modelwhere information resides in a number ofrepositories that can be shared. Theyalready have a unique patient identifier inplace and it is anticipated that thePHIMS will be ‘tethered’ to the EHR.

Norway PHIMS initiatives are mostly in an experimental or pilot stage. EHRs arewidespread, particularly with GPs. A newhealthcare reform, launched spring 2009,emphasises a shift from provider-centredmodels of care to person-centred careapproaches, with people having more participation in care and health promotion, early detection and self management being a key focus.

Slovenia There are currently no PHIMS inSlovenia. All people carry a health card

that contains basic data about healthinsurance. The government are currentlypreparing new personal identity cards,which could in the future be used forhealthcare and provide access to electronic health records.

SwedenPHIMS are not widespread in Sweden.Lack of infrastructure for IT security isbelieved to hamper development in particular, because Swedish law allows thetransfer of individual health data betweencaregivers only with the consent of thepatient. A project ‘Healthcare on the web’is currently underway and intends todevelop more e-services for citizens.

Wales A trial of My Health Online is being conducted at a number of general practices.Patients can book appointments andrequest repeat prescriptions online. Somepatients have access to their healthrecords. These pilots are the first stage inNHS Wales’ plan to provide each personwith a personal electronic health record.

EnglandPatients over 16 with an email can register for a HealthSpace account. Thiscurrently gives them access to a l imitedset of functions, including booking hospitalappointments, managing health andlifestyle, a calendar and address book f orhealth contacts and appointments andlinks to health information. The nextphase of the project is to develop a communication tool for email consultationswith the GPs and other clinicians.

USAMany institutions have or are movingtowards tethered personal health records.Two large health care sys tems with a significant user base are Kaiser Permanenteand the Department of Veterans Affairs.The government has earmarked 19 billionUS dollars for health information technology, including adoption of EHR.

SwitzerlandInfrastructure projects include health carefor citizens and health care professionalsand an architectural vision that is basedon decentralised repositories and portalviews for patients and professionals. Asurvey has revealed that citizens are infavour of EHR and wish to d eterminewhich data can be s tored and who shouldhave access to it.

Key issues on PHIMS The need for governance in relation to health policy, patient engagement, finance and incentives, professional practice, legal issues and evaluation. Features and functionality of the PHIMS should ultimately be designed to underpin self-management of health and health improvement.Multiple care givers mean that there are likely to be multiple users of the PHIMS, therefore features and functions need to consider managementof data remotely. Usability issues need to address us er centered design which may be user configurable, with a dashboard of features and facilities. Uniformed and consistent policies for confidentiality, privacy and security arerequired to ensure appropriate creation, storage and transfer of private health information to support its integrity and appropriate use.There is a need to integrate IT into nurse education at all levels from registration to continuous professional development.Person-centred care and partnership based care models will be the nursing model of the future.There is a need to incorporate an interdisciplinary approach to the use of PHIMS.As people take on new roles and responsibility for their health management, nurses will need to support people developing their health literacy skills. There is widespread recognition of the importance of a professional, patient and healthcare organisations culture that shift the balance of care from the health service to person, family and community. Patients and families can be a driving force in the transition to personal health information management systems as they are increasingly becoming more knowledgeable about their particular health problemsThere will be a shift of control and empowerment to the person as knowledge shifts from clinical control to people. How people experience disease and symptom management should be incorporated into evidence-based practice.PHIMS should be viewed as a tool to underpin nursing practice and should be integrated into the care process.


This stream, human computer interaction,was a first session on the first day of theconference. The presentation ‘The onlinemanaged knowledge network that sharesknowledge for eHealth in NHS Scotland’(Dallest et al) had been submitted underthe theme ‘education’ and we were initiallysurprised to find it in this stream. It wasn’t until after the session that weunderstood why the scientific committeehad placed it there and we’ll will waituntil the end to share our thoughts on that.

Alina Kontio from the University ofTurku, Finland, presented ‘Key elements ofa successful care process for patients withheart symptoms in emergency care – couldan ERP system help?’ (Kontio et al). Thisstudy aimed to identify successfuloutcomes and the flow of patients through

emergency care, and examine where anenterprise resource system (ERP) couldhelp decision making.

They identified a number ofcompetencies within three categories:process, personal and logistics thatdirectly influence successful outcomes forcoronary heart patients. Administrativeand patient process events could beimproved through the use of an ERPacross different areas of the hospital. Thisstudy involved process-based analysis andan understanding of how patients, staffand information flow through the healthsystem.

Debra Wolf, from Slippery RockUniversity in Pennsylvania, USA,presented the paper ‘Nurses usingfuturistic technology in today's healthcare

setting’ (Wolf et al). This study describedvoice assisted technology used by nursesat the bedside to improve workflow,improve patient outcomes, increase nursejob satisfaction and improve electronichealth record documentation.

Nurses in this study use a lightweightheadset and small waist level wirelesscomputer unit. Care is documentedverbally, in a hands-free, eyes-free wayallowing for greater accuracy of recordsand availability of information, a decreasein care-related paperwork and improvedworkflow. The nurse can retrieve datafrom the bedside and also receivemessages, which decreases the need foroverhead paging. Patient safety isimproved through reduction in infectionbecause of reduced manipulation of paper

Human computerinteraction

N I 2 0 0 9 R E P O R T

The human computer interaction stream at the recent Nursing Informatics conference included

a look at the online managed knowledge network that shares knowledge in eHealth in Scotland

amongst other threads. Kathy Dallest, Heather Strachan and Gillian Flett report on what was

discussed in this stream.


records or keyboards. An in-depthunderstanding of the way nurses work andtheir information needs are required todevelop this solution.

Bruno Rosales-Saurer, from Germanypresented ‘Scenario based design of anICT platform for mobile informationservices in ambulatory care nursing’(Rosales-Saurer et al). Greater efficienciesin health care can be gained by deliveringthe right information to the right people atthe right times securely and safely.

This study used a ‘user-centred designprocess’ (ISO13407), which focuses onnot only the information and technologicalrequirements, but the all-importantcontext of the intended users of thesolution. Again, analysis of the processesand related information requirements werenecessary to achieve understanding of thecontext of healthcare.

Nancy Staggers from the University ofUtah, USA, presented ‘Using personas andprototypes to define nurses’ requirementsfor a novel patient monitoring display’(Koch et al). This study looked atindividual preferences in relation toinformation displays through the use of‘personas’. Nurses in an intensive care unitmake care decisions based upon theinformation that is presented to them on apatient monitor.

People interact with information indifferent ways and this study developed anumber of personas to guide thedevelopment of prototypes, which allowsindividual customisation to achieve thebest personal response and decisionsupport and ultimately patient outcomes.Analysis of the information and careprocesses in the context of the ICUallowed the development of the personas.

Vesna Prijatelj from the School ofHealth Science Novo Mesto Sloveniapresented ‘From eHealth to integratedhealth care: theory and practice’ (Prijateliand Rajkovic). This presentation describedthe pathway to integrated healthcare inSlovenia through transformation of healthpolicies and the establishment of theeHealth infrastructure.

The national strategy focuses onachieving a common understanding ofintegration, what is it and how to achieveit. It is tackling the issue on two fronts.The first is a top-down approachaddressing the business requirements andidentifying necessary capability andcapacity building through commonunderstanding. The second approach,bottom up, focuses on individual patient

groups and developing a sharedunderstanding of processes and flow thatsupport decision making for betteroutcomes. Again, analysis of processes andinformation flows in the context ofhealthcare provision is crucial in delivering solutions.

A personal presentationReturning to the presentation, ‘the onlinemanaged knowledge network that sharesknowledge for eHealth in NHS Scotland’(Dallest et al) demonstrated the web portal www.nmahp.scot.nhs.uk, whichhelps clinicians to find out what is goingon elsewhere and to share their experienceand knowledge with colleagues. The sitealso gives access to the NHS Scotland e-library and over 5,000 full text journalsand over 100 bibliographic databases.

A knowledge and information auditwas conducted to find out whatinformation related to what activities wasrequired by these clinicians with a specificjob role in eHealth. Process analysisrevealed activities of strategic significanceand identified the related information. Thiswas crucial in order to deliver a systemthat was useful and useable for theclinicians. What this site and thewww.usinginfo.org site do is to helppeople develop knowledge andunderstanding through informal collectivelearning.

In summaryWithout coming to this conference, wewould not have been able to benefit fromthe personal contact with our fellow presenters. The challenge exists for healthinformatics organisations, through technological solutions, to find a way andto support faster innovation and development throughout their membership.

This session on human computerinteraction highlighted the importance ofuser-centred design, focusing on thecontext and flow of informationsupporting decision making in healthcaredelivery. This contextualisation ‘grounds’technological solution developments.Nursing informatics has moved on pastadapting solutions designed for otherdisciplines and contexts. Nurseinformaticians must be able tocompetently select and use processoriented methodologies and tools todetermine contextualised informationneeds in the evolving integrated healthsystems in which we work and live.


I approached the 10th International NursingInformatics Congress with a set of personal goals,which included finding evidence of any impact onoutcomes from using information and communication technologies in nursing practice andstandardised terminology. The two concurrent sessions on terminology should have provided someof this evidence but, with one exception, this was notthe case. As this report demonstrates, there is stilltoo little evaluation and outcomes research in nursing informatics. Unexpectedly, some new challenges were presented in one of the plenary sessions and in the session on human computer interaction, which I will also mention.

Outcomes researchPatient safety was perhaps the only topic in the programme where there was some concrete evidenceof impact. Given the emphasis in England and Waleson safety of systems, it was surprising that not oneposter or paper considered risk management of

Outcome measures and ethical competence

N I 2 0 0 9 R E P O R T

healthcare applications. I did not come across anyresearch reports where the impact on patient outcomes of using IT and/or a s tandardised language had been measured. A number of postersreported improvements in nursing documentationand there was one trial that used documentation ofoutcomes as a proxy measure to demonstrate careimprovements. This trial was of an educational intervention related to clinical decision-making inwhich the standard terminologies were regarded asthe means for describing and communicating nursing decisions (OP334 - Dr Maria Müller-Stauband colleagues from Switzerland). Discussion following this presentation suggested that improvements in quality and patient experience werethe result of introducing clinical decision making,not simply implementing standardised terminologyfor its own sake. There was also discussion ofwhether existing nursing terminologies such asNANDA are better seen as tools to suppor t decisionmaking rather than as terminologies for use in

The human

computer

interaction and

ethics and nursing

informatics

streams at the

recent Nursing

Informatics

conference

provided Anny

Casey, RCN

advisor on

information

standards, with

a new set of

challenges.


computer systems. As the 2009 Cochrane review of care

planning systems found, there is littleevidence to demonstrate the impact ofsystems on nursing practice andoutcomes. A UK nursing informaticsresearch agenda could consider: the roleof nursing terminologies in qualityimprovement; measurement of impact and outcomes from nurses’ use of IT.

Human factorsSeveral papers in the human computerinteraction session addressed methods forunderstanding and modelling care processes so that systems could bedesigned to support nursing work, ratherthan simply to replicate documentation.Activity, process and scenario based modelling were all reviewed by differentspeakers and limitations of each were

discussed. Critical incident methods werereported in one study as a basis for defining optimum processes and identifyingwhere decision support could be most beneficial. Nancy Staggers from the USdescribed the use of ‘personas’ as amethod for specifying user interface (UI)requirements for intensive care monitoringdisplays. Four behavioural profiles weredeveloped from observational data andinterviews. UI design preferences werethen identified. This was an interestingapproach to the ‘one size may not fit all’challenge – it was a shame that the company that paid for the research thenfocused on the one design that was mostacceptable to all. Ways of tailoring interface displays for different users stillseems some way off, perhaps because ofrisks, but the safety aspects of UI components were not mentioned.

An encouraging ‘future vision’ wasprovided by Debra Wolf and colleaguesfrom the US who reported on theevaluation of a voice system forcommunication and documentation.Nurses wore headsets, which removed theneed for bleeps and allowed them to beupdated with new orders as they weremade. Paperless patient identification hadbeen addressed. Proactive reminders weregenerated automatically from the systemand communicated to the nurses. Benefitsto date have included: reduceddocumentation time; real time, point ofcare documentation (voice to structuredfields in the system); reduced time findingphones or colleagues to communicate;fewer interruptions to answer calls;improved adherence to practice standards.Reduced risks of infection were identifiedas an unexpected benefit – in this hands-free setting, nurses were touching only onedevice to record and communicate ratherthan multiple devices such as keyboard,mouse and phone.

Once again, impact on quality andoutcome were assumed rather thanmeasured – fewer interruptions, more upto date information, more real timecommunication and so on were said tohave improved quality.

Ethical competence For me, the highlight of the Congress programme was the keynote on ‘Ethicsand nursing Informatics’ by ProfessorHelena Leino-Kilpi, Director of theFinnish National Post-graduate School inNursing Science. As a newcomer to thespeciality she had searched the literature

to see whether and how ethical issues wereaddressed in this speciality. Her conclusionwas not well: there is plenty of materialon ‘how to act right/well’, but almost noneof ‘what is right/good’. There were somepublications, from Levine in 1980 on theethics of computer technology to Simpsonin 2005 of ‘e-ethics’. But the concept ofethical competence in health technologywas not evident.

Several ethical codes were mentionedincluding the UK one bu t Dr Leino-Kilpimade the point that codes forprofessionals don’t solve the problem. Sheconcluded that technology can improve therealisation of ethical principles such aspatient autonomy, privacy and informedconsent. However, there seemed to be alack of awareness of the moral dimensionsof decisions, for example, how values couldbias health technology assessment. Sheremarked that technology does not havevalues – designers and evaluators do.Questions need to be considered:

Is the process of assessment/decisionmaking ethical and are ethical criteriaincluded in the assessment? IMIA NI willbe considering this challenge during their discussion about the Research Agenda fornursing informatics (Bakken et al 2008).

Information standardsThere were two panels focused on standards (I participated in both). TheIMIA NI standards group gave anoverview of current standards activity witha focus on standards for the content ofrecords and messages. This was also thetheme of the second panel comprised ofnurses from the UK, the Netherlands andAustralia in which ‘detailed clinical models’ were described and issues fornursing considered.

This is a huge agenda and it was clearthat the major challenges for the next fewyears will be: international co-ordinationaround repositories for content standardsand how to harness the expertise of theprofession to provide the practicestandards that must underpin the contentstandards. There was a clear message thatthe technical challenges of ensuring thatcompeting standards interoperate wastrivial compared with this latter task.

My impression was that the UK is we llplaced to contribute and also to lead oncollaborative work to agree professionalcontent. For example, Derek Hoy’s clinicaltemplates portal provides a platform thatnurses in practice can use to workcollaboratively on practice standards.


My main interest in this year’s NI2009 were thepapers focused on education. Even though my ownpaper (Nursing informatics; is IT for all nurses?Bond; Lewis & Joy) was placed in the clinical workflow strand it was substantially about education.

As I had been placed as the las t of sixpresenters in the late morning session I decided thatthe audience would be tired of being talked to, andkept my presentation short, focusing on the keypoints that nurses in practice face, one of whichbeing that nurse educators and nursing studentsfrequently do not see nursing informatics as beingpart of their clinical skill set. I allowed plenty oftime to let the audience share their own experiencesand views. Although a few felt that they hadexperience of computers and nursing beingintegrated, the majority had encountered the sameattitude we found in our research.

This complements research carried out by theRCN, which members of their Information inNursing forum reported. Their study concluded thateHealth should be an integral part of nursingeducation and not an add-on.

A paper by Dr Amy Bar ton and Dr Diane Skibawas about a project that also looked at nursinginformatics and student’s clinical experiences. Theirpaper was about integrating informatics intobaccalaureate clinical course work with the aim ofestablishing a curricular thread to integrate learningcontent in informatics. They found that students’learned more quickly and efficiently throughcoursework (87.5 per cent) and in the classroom(75 per cent) than they did through clinicalexperience (66.7 per cent).

Jo Foster and Julianne Bryce had explored theAustralian position, and from a survey of over 4,000nurses concluded that although Australian nursesrecognise the benefits of adopting more informationtechnology in the workplace, there were alsosignificant barriers to their use. They also identifiedgross deficits in the capacity of the nursingworkforce to engage in the digital processing of information.

There were numerous excellent presentationsabout systems available, and the benefits that wereto be gained from using them; however, my partingthoughts were that education has to be the bedrockof this. It doesn’t matter what the potential benefitsare, if nurses are not equipped to work with thesesystems they will never be fully recognised.

Moving on from education to one personalobservation from reading the biographies of thekeynote speakers, only two of the seven were nurses. Whilst not doubting the expertise andknowledge of the speakers, and not wishing to beinsular, I was left wondering if the balance was right or if we should be giving more prominence to our own leaders?

Pre-registrationeducationDr Carol S Bond provides an overview of the

pre-registration education stream running

through the Nursing Informatics 2009 conference.

N I 2 0 0 9 R E P O R T


activities using web 2.0 tools andtechnologies: a case study.’ She comparedfeatures of new online learningenvironments with traditionalenvironments, stressing the social need ofconnecting with others (as per Siemen’sprinciples of connectivism), and discussedhow web 2.0 tools/platforms, as well asSecond Life, were used for facilitation oflearning experiences (such as virtualattendance at, or participation in,conferences). Juliana’s students producedan assessed reflective paper on theirexperiences of using Second Life as alearning environment, and there is someevidence that their anxiety in a real-lifesituation is reduced by being able toencounter, explore and discuss thembeforehand in Second Life.

The messages emerging from thisstream complemented those of severalother sessions that I attended, as well asthe workshop on ‘Personal health records(PHR): health 2.0, virtual worlds andmore’ that I presented with Scott Erdleyand Heather Strachan and the panel thatScott Erdley and I presented, on ‘Whatrelevance do web 2.0 applications have fornursing informatics and professionaldevelopment?’ The slide presentation forthe panel is available atwww.slideshare.net/drpeter/

ni2009-web2panel-final, while those forthe PHR workshop are atwww.slideshare.net/erdley

It is apparent that, in manyeducational institutions, we are seeing realexploration of, and research into, the useof web 2.0 tools, as opposed to some ofthe (perfectly valid) rhetoric we haveheard previously. It is also clear, frommany of the presentations, that eventhough we are able to utilise a far widerrange of tools and technologies thanpreviously, many of the same messages

Betsy Weiner, of Vanderbilt University,Nashville, USA addressed the emergenceof what she termed educational informatics, starting from an outline ofwhat she saw nursing informatics as being (and not being – she firmly sees itas far more than simply IT skills and computer literacy).

Betsy gave several examples of the useand range of technologies to support thedelivery of nursing informatics education,including high fidelity simulations forlearning and practising skills, andexploring the use of virtual worlds, such asSecond Life, for educational simulations.Her message focused on the challengesfacing nurse educators in applying thescience of informatics, and not solely theeducational technologies, to push theenvelope in exploring how new andemerging technologies and approachesmight be of benefit.

Presentations from AnnikkiJauhiainen, of Savonia University ofApplied Sciences, Finland and from TrondIndergaard and Berit Stjern, from Sør-Trøndelag University College,Trondheim, Norway, both describedresearch studies into their experiences ofsupporting the development of clinical and learning skills in a problem-basedlearning curriculum.

While they both covered similar issuesand relayed similar messages about thebenefits of their approaches to supportlearning, they used differing underlyingtechnologies. While Annikki explored theuse of web-based elearning tools,

including web-based conversationalapplications, Trond and Berit’s study was based on the use of video-conferencing technologies.

The final presenter was Juliana Brixey,from University of Kansas, USA, whoaddressed ‘Creating experimental learning

Educational informatics,web 2.0 and learning

N I 2 0 0 9 R E P O R T

that we have heard over the past 20-30years remain valid. These are that nursingand health informatics, whether ineducational or clinical environments, arenot just about gaining the basicinformation technology or computing skills– although often they are s till taught as ifthese were the most important skills.

The clear message is that thos e of usinterested in exploring the newtechnologies (e.g. web 2.0 tools andvirtual words) need to be careful that wedo not appear to be simply uncriticallyfixated on the technologies for their ownsakes, but need to ensure that we getacross the messages that we are cr iticallyexploring the possibilities of their use.

Along with several long-standingcolleagues, and some new ones w ho weredipping their toes into web 2.0 tools, Iprovided blog posts on many of thesessions, and experimented with Twitter toprovide ‘live’ reporting on the event. Ourblog posts can be found at www.hi-blogs.info while the Twitterstream for the conference is atwww.twitter.com/ni2009 and othercontributors’ tweets can be found bysearching Twitter with the hashtag #ni2009.

The stream 'Teaching methodologies 2' of this year’s Nursing Informatics conference contained five

presentations covering a variety of educational aspects of health and nursing informatics and of using

technologies to support educational delivery. Dr Peter J. Murray discusses each of them in turn.


The conference, which this year was held in The Gallery Suites at the National Exhibition Centre, Birmingham on 4 June,attracted over 200 delegates to hear Christine Connelly and Tim Straughan deliver keynote presentations, to participate in a selection of interactive workshops on topics of national importance and to network with peers, ASSIST Partners andother sponsors/exhibitors in the open exhibition area.

The event was opened by Br ian Derry, Chair of the ASSISTNational Council who welcomed all the participants andintroduced Christine Connelly, Director General for Informatics at the Department of Health who gave an inspirational openingkeynote presentation on quality informatics, the CIO’s perspective.

Voted a success - ASSIST 2009 National Conference

S P E C I A L I S T G R O U P R E P O R T

Overwhelmingly positive feedback was

received from delegates regarding the 2009

ASSIST National Conference which featured a

number of key speakers and a wide range of

workshops. Phil Paterson, ASSIST National

Events Co-ordinator reports.

Christine Connelly and Tim Straughan


Christine stated that the NHS is on ajourney that started with the NHS Plan of2000. The first phase was to increaseinvestment and capacity. The second phasewas to develop levers to expand choiceand contestability. The third phase (definedin the Next Stage Review) is to raise thequality of health care for patients.

The culture of society has changed soit is no longer appropriate to have ‘onesize fits all’. The NHS has moved toprovide patient choice with the boundariesof where care is delivered becomingblurred. However, quality is the organisingprinciple captured in the Next StageReview and it has been d efined as havingthree elements:

it is safe;the treatment is effective;the patient experience is good.

There is also the expectation that the service will become more productive withinnovation as the link to drive improvements in quality and efficiency. The need for greater innovation should beexciting for health informatics.

Christine felt that ‘information needsto be of a high quality for use by patients,staff and the public.’ She went on to say‘there is the challenge to capture the dataonce, store it and re-use it. Informationhas to be delivered swiftly to people sothey can innovate how they use it and use it to innovate. Information has tosupport change.’

Connelly felt that ‘health informaticsprofessionals should be challenging theircolleagues on innovation. They need to bemore confident, bolder and more assertiveto drive innovation. The future is aboutworking in teams and informaticsprofessionals need to help teams makemore use of information.’

Tim Straughan, Chief Executive of theNHS Information Centre for health andsocial care (NHSIC), opened theafternoon programme by highlighting therole of informatics professionals in thedelivery of the Next Stage Review. He toldthe conference there are three key issuesfacing health care across the world. These are:

raising the quality of care;the economic downturn and its constraining impact on health service budgets;using information to address the first two issues.

It is absolutely essential that the CIO is atthe top table to drive innovation in boththe use of proven technologies and theexploitation of the information they canprovide. We have to measure to know if weare improving and this includes clinicalquality, world class commissioning andpayment by results and efficiency. (Thefirst two of these areas were the subjectof workshops facilitated by theInformation Centre).

Tim said: ‘we have got to measure theright things and measure them correctlyand consistently. This will necessitatestandardising the measuring.’

The vision is to have relevant, accurateand timely information. The mission is touse this to improve health care. All thiswill put the spotlight on data quality. TheNHS IC is supporting a major programmeto support local and national improvementsin data quality.

Three times during the day thedelegates split up to attend a workshop oftheir choice from the six concurrent,interactive workshops that were run on thefollowing topics:

clinical metrics;electronic document and records management;social care;Summary Care Record and HealthSpace;technical innovations in health care – the CIO’s role in ‘the hospital of the future’;world class commissioning and its impact on informatics.

The workshops were facilitated by a combined total of 16 workshop leaders,all experts in their field. At the end of theconference plenary session a leader fromeach workshop gave a brief report of thetop three issues arising from their workshop. A common theme arose, thathad also been featured in both the keynoteaddresses; interoperability is a major challenge in health care – bu t includingsocial care converts it into a nightmare.Add in the governance and people aretempted to park it in the ‘too difficult’ category. It is an issue that wi ll have to betackled if we are to suppor t the improvements in care required by many patients.

Likewise in terms of technicalinnovation there is often a large initialcost for infrastructure, which tends to putpeople off; there is a need to phas e this in

bite size chunks and keep a rollingprogramme in terms of both cost andadditional benefits. This echoed part ofChristine’s Connelly’s message aboutdelivering projects in bite-size chunks,delivering the major elements early whilstleaving less frequently used features untillater – and checking each chunk with theusers to ensure it meets requirements.

Health informaticians will be needed tointerpret ‘indicators for qualityimprovement’ (IQI) to enable managers toget the most benefit from them. Healthinformaticians should also ‘push’information, with interpretation, for worldclass commissioning. There is a role forASSIST to develop thinking on thesharing of information in relation to thePlanning Framework developed by TribalGroup for Electronic DocumentManagement for Health Records.

The message from the very popularsummary care record workshop was thatimplementation of the summary carerecord is now a communications project,involving PR and change management. Itneeds to have buy-in of GPs and otherclinicians. The local communications teamneeds to be dedicated to it for nine monthsand it needs a high level champion: theChief Executive.

Finally, a recurring theme from all thepresentations was ‘manage the culturechange.’ Overall the conference was bothan operational success and financialsuccess and attracted 20 new members toBCS ASSIST. For more information:www.bcs.org/upload/pdf/assnljul09.pdf

AcknowledgementsThe conference could not have taken placewithout the support of ASSIST’s nationalpartners and other sponsors. The work-shops were sponsored and facilitated bythe NHS Information Centre, NHSConnecting for Health, BT with Norteland Tribal Group. All these organisationsand ASSIST national partners max20 andFine Green Associates had stands in theexhibition area, along with BCS,BlueWare, Cloud2, Logica, Perot Systems,Tracline and UKCHIP.

Author’s note:

This article is based on an adaptation of

the conference reports by John Leach

that appeared in the July 2009 issue of

the ASSIST Newsletter. More details of

the conference presentations are on the

ASSIST web site at: www.assist.org.uk

N I 2 0 0 9 R E P O R T

With the increasing focus on ensuring thathealthcare is based on good qualityresearch evidence, one of the challengesfor the informatics community is developing strategies for helping cliniciansto access and use that evidence in theircare effectively.

The six papers in the session discussedvarying types of technology: PDAtechnologies used by individual nurses,remote monitoring of patients in their ownhome using sensors and varying ways ofproviding evidence to users (e.g. throughthe use of ‘profiles’ for evidence-basedinformation, through the provision ofevidence-based reports to managers).What was common amongst them wastheir aim of trying to improve patientcare, through better management ofinformation available to clinicians or nurse managers.

Lynn Nagle (Canada) provided anoverview of the challenges involved inproviding evidence to nurses in a way thatwill improve patient care. She highlightedthat the role of technology may be to help

nurses transform the way they practice, sothat we can ensure we are do ing the rightthing to patients at the r ight time. One ofthe technologies discussed in thepresentation was the use of a PDA toprovide nurses with up-to-date evidence toinform their practice, at the point of care.However, the potential utility of theseapproaches to help nurses become effectiveinformation managers has yet to be realised.

Lorrie Roemer (US) discussed asystem that has been introduced inIntermountain Healthcare, to helpclinicians accurately calculate doses ofsubcutaneous insulin. The application isweb-based, and uses patient specificinformation (such as the patient’s weight)to provide specific guidance on the dose ofinsulin a patient should receive. This isthen translated into patient specific ordersheets for the guidance of patient care.The system is now widely in use acrosstheir hospital system.

Hannah Aschan (Finland) provided anoverview of how a number of hospitals inthe Helsinki area are using the data

Evidence based


provided by RAFAELA to inform nursestaffing decisions. RAFAELA is a patientclassification system that uses informationabout patient dependency, nursingresources and what the optimum level ofnursing care should be on a hospital ward.It also provides feedback to managers onwhether the nursing resource is at theoptimum levels for the care needs of thepatients on the ward. The output from thesystem can then be used to make nursestaffing decisions.

Michael Marschollek (Germany) gavean overview of how data from the smarthome laboratory can be used to populatethe Arden decision support system. In thelaboratory, data from a number of sensorsis collected by the decision supportsystem, which can then highlight whenabnormal values are detected, which mayindicate a cause of concern for a patient.With the increase in the number of elderlyindividuals who have health problemsliving in their own homes, it is hoped thatthe results of this work will provide point-of-care support for patients in theirown homes.

Paula Proctor (UK) discussed asystem for providing nurses with up-to-date evidence, to help inform theirpractice, using a user profile, which thenurses used to document their needs forevidence. Software then searches pre-approved quality databases for theevidence to support the nurse’s practice,before dropping the results back in thenurse’s user profile. In this way nurseshave up-to-date evidence to inform theirpractice, based on their own identifiedinformation needs.

Finally, Judy Murphy (US) gave anoverview of the Knowledge Based NursingInitiative (KBNI) based at AuroraHealthcare, Wisconsin. The paper outlinedthe overall framework for the KBNI, andthe way in which research evidence hasbeen embedded within nursing care planson the Electronic Health Record. Thepaper also discussed the importance ofhaving a number of ‘transformer’ nurses,who were involved in translating theevidence into the electronic care plans,and who were crucial for the successfulimplementation of the KBNI into pilot sites.

The majority of the systems describedduring this session were in the pilotingphase of their development. Although theyappeared to have some potential benefitsfor helping nurses deliver evidence-basedcare, their eventual utility in practice stillneeds to be further evaluated.

Dawn Dowding reports on the strand of the NI2009 conference

that focused on different ways of providing evidence to clinicians

to help them make decisions at the point of nursing care.


F O R T H C O M I N G E V E N T S

SeptemberASSIST: North West Branch17 SeptemberMap of medicineGateway House, Piccadilly, Manchesterwww.bcs.org/assist/northwest/events

ASSIST: Yorkshire & Northern Branch18 SeptemberNHS organisations – one of a series of events aimed at demystifying the NHSThe Cairn Hotel, Harrogatehttp://northern.assist.org.uk/Events/Current%20Events.aspx

BCS Health Informatics Scotland21-22 September Conference on interoperability standards and patient access to records Scottish Health Service Centre, Edinburghwww.scotshi.bcs.org.uk/

BCS PHCSG 29th Annual Conference24 – 26 SeptemberData sharing – the virtual naked patientCrew Hall, Cheshirewww.phcsg.org.uk

ASSIST: London and South East Branch29 SeptemberMeasurement for quality – a joint conferenceBCS Office, 5 Southampton St, Londonwww.bcs.org/assist/londonse/events

Health Informatics (Northern) Group30 September The NHS Haemophilia Service and the work of MDSASwww.hinorth.bcs.org.uk/

OctoberASSIST North West Branch8 October Sharing information between health and social careWrightington Conference Centrewww.bcs.org/assist/northwest/events

ASSIST: Yorkshire & Northern Branch30 OctoberIdentity managementJohn Charles Centre for Sport, Leedshttp://northern.assist.org.uk/Events/Current%20Events.aspx

NovemberASSIST North West Branch13 NovemberCare record access at Liverpool PCT + update on Bolton SCR PilotUniversity of Liverpoolwww.bcs.org/assist/northwest/events

ASSIST: London and South East Branch18 NovemberLooking into the future: emerging technology and its use in supporting health care dataBCS Office, 5 Southampton St, Londonwww.bcs.org/assist/londonse/events

Health Informatics (Northern) Group25 NovemberRobotic surgery – achieving the promisewww.hinorth.bcs.org/uk

DecemberASSIST: Yorkshire & Northern Branch1 DecemberThe great christmas debateJohn Charles Centre for Sport, Leedshttp://northern.assist.org.uk/Events/Current%20Events.aspx

BCS Health Informatics Interactive Care SG 4 DecemberMedicine on the edge with Surgeon Captain Peter Buxton, OBEBCS Office, 5 Southampton St, Londonwww.hiicsg.bcs.org/events.htm

January 2010ASSIST: Yorkshire & Northern Branch29 JanuaryFrom HRGs to PbRs - finance in the NHSThe Cairn Hotel, Harrogatehttp://northern.assist.org.uk/Events/Current%20Events.aspx

Documents

ROUND-UP SHEILA BULLAS - British Computer Society SHEILA BULLAS In this issue we celebrate the UK involvement at the worldwide nursing informatics conference, NI2009. There was a strong