Volumes have been written, over millennia, about the Doctor-Patient relationship. Recording what goes on during such an encounter is relatively recent, and has multiple functions, including:
- To help the patient remember important information
- To pass on information to other professionals
- To protect the patient from assault
- To protect the clinician from litigation
- To satisfy 3rd parties, including relatives, regulators and the public
The format varies according to the purpose and can be a source of endless disagreement.
Wouldn’t it be better to have a complete, impartial record of everything that went on? A bit like the ‘black box’ recorders in aircraft.
As an anaesthetist, I spend considerable time during the operation manually recording vital signs, which I could fabricate if I so chose. Automatic medical device output is better, but still subject to interpretation; if the oximeter falls off the patient and shows a dangerous level of oxygenation, how is this validated and verified?
If a total record (audio/visual and device output) were available, there would be much less room for argument. This would provide a high-fidelity recording of the encounter, reviewable information for the patient and other clinicians, and perhaps most importantly, for interested third parties.
Currently, wise doctors insist on having chaperones present during sensitive consultations, etc. A ‘digital’ or ‘electronic’ chaperone would be impartial and even more reliable.
The technology is beginning to emerge to enable a digital chaperone of each and every doctor-patient encounter.
Robert Wah and I attended this, invitation-only conference, hosted by Jon Hoeksma, at Lincoln College, Oxford, on 4th and 5th July. Robert was the guest after-dinner speaker and was his usual brilliant self! He talked about his health IT experience in the US navy and the Department of Defence, and his upcoming role as President of the American medical Association. This greatly consolidated CSC in the minds of UK clinical leaders as an authority on global health IT.
The event itself comprised around 35 of the UK’s most influential health IT leaders (see attached), and was a great opportunity for networking and sharing learning amongst delegates. Keynote speakers were from the DH, including Dr Mark Davies, of HSCIC, and Prof Jonathan Kay, National Director for Clinical Informatics. A site visit to Oxford Radcliffe was made, but despite the Chatham House rule, all supplier contributors were excluded at the insistence of Cerner! Instead, we took part in a ‘supplier round table’ event with the clinical leaders from Cerner, Dell, McKesson, and Harris, on ‘Building trust and sharing best practice: developing the role of supplier CCIO’. This illustrates the importance of medical camaraderie, as it’s hard to imagine non-clinical executives of these companies undertaking a similar meeting.
The overall feel of the two days was one of enthusiasm and excitement at being at the vanguard of a revolution in the way we ‘do business’ in the NHS. The mood was congenial and optimistic.
- ‘Haiku’ presentations. These were 2-minute introductions from each delegate explaining who they were and sharing two or three key things they were working on
- Dr Joe McDonald explaining how the CCIO network might develop
- Dinner at Lincoln College, followed by Robert’s address
- Galleria Walk. 30-minute, small group presentations by delegates describing ‘hot’ topics, such as clinical engagement, usability and change management. Dr Colin Brown was very supportive of Lorenzo and has huge credibility as someone who has ‘done it’. I especially liked him telling McKesson’s CMO that Lorenzo was ‘great’!
- Phil Collerton, the Managing Director of the Uptime Institute, (which I’d never heard of). Everyone was fixated by the description of the shocking state of IT infrastructure in the NHS and how professional IT companies could help. To my delight, he called out ‘exemplars’ of good practice in the industry, which included CSC, but none of our health IT competitors! It seems CSC is a member of the Uptime Institute. This drew admiring glances from everyone in the room towards me and Robert. It was very gratifying, and illustrates an important aspect of doctors’ mentality; we like high standards and professional competency. CSC should sing this from the rooftops.
So, overall, a really worthwhile event. CSC, Dell and Cerner sponsored the event, and we had prominent marketing available to delegates. I feel we should continue to exploit such events, and Robert is already lined up to speak at the EHI main event in November. I believe that CSC’s clinical credibility is second to none in the industry.