The heavy burden of data gathering on midwives and the search for clinical systems suited to midwifery practice were common themes at “Due Data”, a meeting organised by the EHI CCIO Leaders Network and the Royal College of Midwives.
Opening the meeting, EHI director, Linda Davidson, said that midwives had always been in lead in sharing information with pregnant women via the shared maternity record but there were some serious issues to be tackled in midwifery data management and information use.
“Managers have voiced their frustration to me that they are expected to produce ever more detailed information about their services and analysis of their performance with vanishingly little informatics support.
“Clinical staff, especially those in the community find themselves dealing with multiple systems many of which do not talk to one another and offer little or nothing back in terms of information to support their practice.
“While some have digipens and laptops, others still struggle along with pen and paper and duplicate data entry,” she said.
A positive example of electronic maternity record keeping came from Claire Brookes, clinical services manager, and Sharon Hackett, midwifery services manager, of Portsmouth Hospital NHS Trust. They described their award-winning service transformation using digipens and BlackBerry smartphones in the community to record and transmit information to records.
The service, which took the top prize in last year’s EHI Awards, introduced digipens for recording maternity information which can be sent to central records via the smartphones.
Benefits have included success in freeing up time to care for women and babies, reduced travelling time, some changes in working practice, the eradication duplicate entry and greater support for lone workers.
Planned developments include: a pilot site for a Personal Child Health Record (PCHR – the RedBook online); links between community midwives and the hospital maternity unit and linking community midwives with pathology services.
Patricia Reilly, IM&T clinical systems manager at the Countess of Chester Hospital, who is about to re-enter midwifery practice, spoke of the difficulty in finding systems that supported the profession’s work. So many systems on the market were from the US where there were few midwives and the role of the obstetric nurse was very different.
“I haven’t found a system out there that I would like to buy yet,” she said. Was a national solution the answer? she asked.
Reilly said it was vital that midwives got involved with informatics and made sure all their requirements were recorded before procurement of a clinical system started. She has listed 900 so far.
Bringing clinical knowledge into the IT department was invaluable, she said. Equally, those in clinical practice needed to engage with their IT departments.
“I hate to have people moaning about the IT department when I could do something about it [the source of the problem],” she said. “I wish they would send an email or stop me in the corridor.”
She echoed a general concern at the meeting about the amount of data midwives were collecting.
“There are 151 items in the new Maternity Minimum Data Set. We seem to collect lots of data but analyse only a small subset. We must do the data collection but there is little guidance on how to do it.”
Julie Tindale, who served as national clinical lead for midwifery at the Department of Health Informatics Directorate (DHID) and Connecting for Health and is a member of the Maternity Dataset Implementation Group, pointed out that without data collection for secondary uses, the answers to important questions about maternal and child health would not be known. Actual birth rates, mode of delivery of the baby and preset feeding rates at six weeks after birth were among the issues she cited.
She listed the Maternity and Children’s Data Set (MCDS) benefits:
However, Tindale acknowledged the difficulties in finding an up-to-date clinical system that has a support department that is able to ‘speak maternity’.
She suggested that the solution could lie in midwives sharing best practice; signposting to systems that work and forming local networks choosing shared or collaborative systems.
The meeting was supported by CCIO Leaders Network Foundation Sponsor: BT, Cerner and CSC.
© 2012 EHealth Media.
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The Information Centre welcomes this rallying call across all healthcare professions. Clinicians need to take professional responsibility for the data that describes their activity, it is only then that we can ensure that data quality accurately reflects what happens to patients. The clinical community are used to using local information to improve services , their influence and leadership is essential in ensuring that the same applies to national information. The CCIO role will help provide the engagement needed to deliver the service and cultural changes required, across professional as well as organisational boundaries.
We at Citadel Events believe that involvement and ownership is key to successful projects. As a recognised leader in the organisation and management of healthcare and informatics events it is clear to us that it is vital for senior clinicians to engage in and lead health informatics projects, so it is natural for Citadel Events to put our weight behind the CCIO campaign.
Speaking in support of the CCIO campaign Steve Bryant, Chief Executive Citadel Events said “Clear leadership and purpose provide the basis for successful projects, the transformation of healthcare services through the exploitation of information and information management systems requires leadership and commitment from those responsible for delivering patient care. We fully endorse the campaign for NHS Trusts to appoint CCIOs.”
The North East Clinical Health Informatics Forum members are from a range of disciplines and sectors. Forum members have a keen interest in how 'enabling technologies' can support the delivery of efficient, effective high quality care, working collaboratively to facilitate clinical involvement in technological advancements within their organisations.
The members firmly believe that the key ingredient to the appropriate and successful use of these technologies within the NHS is Clinical Leadership and engagement from 'ward to board'. The Forum wholeheartedly endorses the campaign and will support the delivery of the 'vision' in any way it can.
I act as a "Clinical Lead" yet have no job description! I've tried for years to act as a translator of Informatics principles into both IT and clinical circles with varying success, so this motion to develop a specific role carrying an identifiable set of responsibilities can't come soon enough. It's about time we ensured that clinicians and IT specialists are brought together consistently to ensure investment is properly rewarded in outcomes.