You may well wonder how a graduate of Arabic and Modern History ended up in the world of health informatics and I have to admit…purely by accident. After gaining my degree, I worked for BBC Monitoring, part of the World Service, as a researcher on the Middle East. This gave me the opportunity to learn the skills of ploughing through reams of information quickly, making comparisons with other sources for accuracy, extracting the key points and summarising them into reports whilst still using the language I had studied.
Then, when a move back to Scotland beckoned (where there is little call for Arabic speakers), I spotted an advert for a job where the main criteria were an ability to work with data and report on it as well as sound knowledge of the NHS. Ignoring the sound knowledge part, I applied and was lucky enough to find an employer who was looking to move away from ‘just producing numbers’ to analytical reporting, and with the warnings of ‘steep learning curve’ and ‘you’ll either sink or swim’ ringing in my ears, I took the job as Corporate Information Manager at Tayside Health Board and stayed for two years.
A further move back south of the border led me to Leeds Teaching Hospitals NHS Trust, initially working in performance information and, latterly, as a Clinical Information System Manager.
After six years in health informatics, I still dread the question: ‘So what do you do for a living?’ This is not because I dislike my job (I don’t), but for two reasons. The first is the blank look you get when you mention health informatics and the second is that, at the mere mention of analysis, numbers and IT, people begin to glaze over. Trying to describe health informatics in a sentence just doesn’t do it justice. Health informatics covers everything from IT staff to information analysts to librarians.
I work in information management. In general terms, this involves turning health-related data into information that can be understood and used locally, ultimately to improve services for patients.
Information management at Leeds
Leeds Teaching Hospitals Trust is one of the largest in Europe and the information teams within the Trust reflect this. Whilst many smaller trusts have one team, Leeds has a number of small teams each specialising in different areas ranging from external reporting to the Department of Health to close information support for individual specialties within the Trust. My team sits in the middle of this spectrum providing operational support for the capture and reporting of clinical data for both direct patient care and audit purposes.
As a manager for clinical information systems, my job is to encourage even the most ‘IT-shy’ people to collect clinical data electronically to provide an evidence base for improving services and patient care.
Currently, the Trust is rolling out a new Clinical Information System (CIS). It will allow clinicians to record more in-depth clinical data about patients both to improve clinical care and to support clinical audit. This is a vast project and my role within it is to lead on the development of processes for data capture, maintain data quality, write queries to report on the data held within the system tailored to each user’s requirements, ensure that national audit data is submitted accurately (and on time) and manage the team of data managers who support the users of the system within each specialty.
Clinical information system
My team provides day to day operational support and training to all users of the system. The users are wide-ranging and include secretaries producing letters for a patient’s GP, medical staff recording in-depth information on treatment and procedures and patients themselves, who fill in questionnaires on the outcome of their treatment via touch screens. With such a wide user base and the added complications of junior doctor rotations, there is never a dull moment.
As with every IT system, you have good days and bad days – glitches in interface links with other systems are a common source of a bad day, a successful ‘go-live’ with a new set of users or specialty is always a good day but getting through a major software update in one piece – that verges on the miraculous!
Reporting and audit
One of my key roles is to promote good practise within data collection and collation to ensure that the resulting analysis we provide is both accurate and comprehensive. We provide analysis of the data collected for appraisal of consultants and clinical audit purposes. We have a mixture of routine and ad hoc work. A typical example of routine reporting would be uploads to the National Joint Registry on the types and quantities of implants used at the hospital.
Ad hoc requests for data vary enormously and you can never predict what you will be asked for next. Analysis can take a few minutes (how many hip replacements have been done this year?); or can be more substantial (looking at patient outcomes taking case-mix into account). Either way, as an information manager or analyst, you either love or loathe the phone call that begins ‘Can you just…’.
Working in health informatics
The best and the worst thing about health informatics and information management in health is that, as a relatively new profession, it is constantly changing. On the one hand, this means that you get to develop your role to suit your strengths and there is always a new challenge or a new subject to investigate but on the flip side, training tends to be ‘on-the-job’ and you have to be able to muddle through, which can be frustrating if, like me, you like to dot all the Is and cross all the Ts.
If you have an eye for detail and enjoy the challenge of continually learning something new, it is well worth the effort. Whilst the majority of those I have worked with will openly admit that they have fallen into these jobs by accident rather than design, in spite of the steep learning curve, we do appear to have learnt to swim!