BCS, The Chartered Institute for IT, has published a report entitled “Building a clinical satnav for practitioners and patients”, produced by authors Jack O’Sullivan, Jeremy Wyatt and Philip Scott.
The report calls for computer-driven support for diagnosis and other clinical decisions to become a mainstream part of the NHS.
“There is an opportunity to develop, at last, what the doctor-patient relationship is designed to deliver: a dynamic link between scientific learning and what’s known about the person,” the introduction notes. The authors highlight that this transformation is hard to achieve as although computers can read and perform tasks, they “cannot use journals and guidelines to apply knowledge.”
As such, “computable knowledge is key…. we need to format healthcare knowledge into a standard computable form. This translated knowledge needs to be stored in a quality-assured e-library that people and systems can access using open standards. There is a growing momentum behind the need for computable knowledge. But there is still a lot more to be done to make sure it’s standardised and properly quality assured.”
The report asks, “how can we create safe but fast point-of-care decision support, given that digital publishing tends to drive out quality and nuance?” and sets out ten key challenges to achieve this goal, based on interviews with a working group on computable knowledge organised jointly with the Faculty of Clinical Informatics.
The authors highlights the challenges: healthcare knowledge is complex and requires precise expression; who decides what knowledge is computable?; connecting electronic patient records to healthcare knowledge; data must be complete, and decision-support prompts well-designed; computable knowledge needs to be accessible, with updates built in; multi-disciplinary working is vital for quality assurance; coding health knowledge and updates into formats that computers can interpret; healthcare decision-making must be a step-by-step process; regulating and monitoring the development of decision support; and leadership and strategy.
Dr Philip Scott, Chair of BCS Health and Care, said: “Computer-driven, healthcare decision support already exists to a limited extent, but we must catch up with other fields. In banking, shopping and travel, computational support for personal and expert decision-making is commonplace and often seamless. Peoples’ needs are understood so intimately that there’s little difficulty recommending suitable films, food and holidays for them.
“The great opportunity now is for clinical research to produce computable knowledge that can be used immediately in computer-driven decision support, with the unique chance to transform patient outcomes and how doctors work.”
The report can be read in full here.
