Project Rationale Dr Nick Booth Aims of the

Project Rationale Dr Nick Booth Aims of the

Project Rationale Dr Nick Booth Aims of the project Create a grounded framework for a federated information service for the NHS in England Create an environment in Durham and

Darlington ready to procure an integrated clinical record service by the end of the project in September 2002 Customers of the project NHS in England (national reference architecture) Health Community in Durham and Tees

Valley Strategic Health Authority area (1.2 million people) Principles of the project Ethical and Legal foundation for a shared information service Based on informed patient consent

Prime inter-organisational clinical information source Grounding in real clinical work Engage clinicians in coherent design understanding (using ethnography) Project themes

Ethical Framework Security Framework Ethnography Educational tools to facilitate user engagement

and informing the architecture (ANIMATORS) Simulated commercial product reflecting the architecture (SIMULATOR) Governance framework Enterprise architecture Projections of enterprise architecture cover:

Organisation Resources Functions

Technologies Governance Characteristics of the information service

Open Flexible Scaleable Federable Cope with legacy

Framework for other standards Record architecture Terminology

Classification Messaging ENV 13606 prENV 13940 Read, SNOMED, Drug dictionary HL7

Conceptualising problems in Architecture Abstraction and Parsimony Computing science Exemplification and specificity Medicine and surgery

To move toward shared understanding we exemplify concepts in animators Location of work Primary care General practice / Multidisciplinary care teams Transitional care

NHS Direct Out of hours services Paramedic /ambulance Hospitals (Acute services) A+E ; CCU; Acute medical wards Context of work

Interdisciplinary Care pathways Coronary heart disease National Service framework Co-ordinated care within and between health care organisations Cultural issues of trust related to information sharing

From discourse to understanding Coherence of vision of EHR

System vendors NHS informaticians, clinicians, managers Local and national policy Academics Facilitate cultural change Clinically led innovation Dynamic local reconfiguration

Informatics services as facilitators not leaders of the change process Technical Animator

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