CHI+MED’s Prof John Williams interviewed by BCS about patient records & role of CCIO

BCS recently spoke to Professor John Williams, Director of the Health Informatics Unit at the Royal College of Physicians, on the ‘mission’ of the college, on their ‘Future Hospital’ project and regarding the role of the college in developing the role of CCIO.

Transcript of interview below

My name’s John Williams, I’m a physician. I work in Swansea in South Wales and I also direct the health informatics unit here at the royal college of physicians.

What is the mission of the royal college of physicians?
The mission of the college is to raise standards in healthcare. To improve safety and to raise quality. Underpinning quality are records, patient records, and it is essential that we improve the quality of recording in patient records and communication of information between professionals, and between professionals and patients.

The work of the college has been focused very much on improving records and one of the problems that we’ve found is that there are different records underpinning the care of different diseases, used in different departments, used to record different information about different interventions, and the vision that we have articulated is that we need records that are focused on the individual patient so they’re not distributed across the hospital in different forms, supporting different aspects of care. Instead they’re focused on the patient so that when a patient with many different disorders encounters different departments and is looked after for different diseases there is a single record in which all the information about that patient is held. Now we’re not saying necessarily that physically it’s a single electronic record, but it must be put together in such a way in different areas, different departments that is accessible as a single record.

If that is to happen there need to be standards for the structure and content of the record, so that when information is recorded, when it’s communicated, it is communicated, it is recorded in the same away so that the records are interoperable.

The hospital of the future
A major project at the Royal College of Physicians is to explore the structure and function of the hospital of the future and this will look at all aspects of the hospital in the future. Dispensing with conventional ideas as to what it should look like and how it should perform and to come up with new ideas that meet the needs of the 21st century and takes advantage of new technologies. We are looking to see how records and communication and new information technologies should be harnessed to underpin the work of the hospital of the future.

What is the college’s role in driving leadership?
The Royal College of Physicians plays a major role, from a professional perspective, in leading the development of services and the delivery of high quality care.

This leadership applies to new technologies in healthcare and developments in in-patient records, setting standards for the structure and content of those records and improving communication. There is a campaign to develop Chief Clinical Information Officers (CCIO) in healthcare, the role of clinicians in supporting information and information technology in healthcare – and the College is fully behind this initiative. The Chief Clinical Information Officer role is very important, so that there is high level clinical leadership to improve the quality of patient records, the quality of data captured in the records, the communication between professionals and the use of aggregate information – extracted from records, to support the developments in healthcare, monitoring of performance, audits of quality of care, and the use of data for research.

The latter two are very important. At the moment there are multiple different audits that occur at a national level, such that we’ve heard some Trusts have to contribute data extracted from patient records for up to 50 national audits at one time. That is hugely resource intensive. If there is clinical leadership, if there are records that collect the data in structured form, that is the same across all disciplines, then those audits can be conducted using electronic data extracted from records. And the same applies to research. It should be possible in the future to conduct prospective clinical trials. Much of the data coming from patient records, data captured at the point of care, rather than design data that is collected specifically for that activity. This would enable much larger trials, involving more patients, conducted more cheaply and answering questions about healthcare that are truly pragmatic, in other words, looking at whether interventions help in the reality of healthcare.

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