The role of informatics in paramedic practice

Patient safety and understanding informaticsSo, what has informatics got to do with patient safety? The Department of Health says that:‘Improving patient safety involves assessing how patients could be harmed, preventing or managing risks, reporting and analysing incidents, learning from such incidents and implementing solutions to minimise the likelihood of them reoccurring.’This is something that is arguably all the more important in the shadow of the recent Francis report.Patient safety is all about the systematic gathering and intelligent use of information, and implementing systems and technologies to support those activities.Three important developments in health informatics are: implementing electronic patients records (EPRs), providing real-time access to evidence of effectiveness, and increasing the use of information and communication technologies (ICT) in the community.EPRs enables routine recording of patient information that can be automatically coded for secondary uses and facilitate feedback for clinicians. There are two essential pre-requisites: standardised record headings and nationally agreed clinical language.The use of nationally agreed record headings will provide a consistent context across the NHS for each type of data, e.g. care, interventions, or treatments that are provided. The Health and social care information centre (Hscic) is currently looking at working towards ambulance data standards, commencing with discharge summaries.The use of systematised nomenclature of Medicine clinical terms (SNOMED ct) clinical coding system, which is the only system approved for use in the NHS.The implementation of EPRs will provide the technology to support patient information being recorded once and used many times for a multitude of purposes.The routine recording of coded patient information under standardised record headings, by all care providers, will greatly reduce the burden associated with recording high-quality data when carrying out service evaluations, and local or national clinical audit and research, which in turn will lead to improved patient safety.A second informatics component concerns providing access to evidence of effectiveness to support care planning and interventions in real time. Several organisations provide information online to help patients and carers to be better informed, or to support clinical decision making by health professionals.A third informatics component is the use of ICT to enable patients to live in their own homes safely and for longer. Telecare provides monitoring of vital signs and alerts staff when problems arise. Telehealth provides better communication to enable remote consultations and professional support to complement home visits. Both of these components are likely to be significant in the future practice of paramedics and ambulance services with remote access to patient information, to telemedicine support from colleagues at a different location, or to online information to support clinical decision making. Summary Care Record and its future iterations will play a key role in the future.

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