Publishing knowledge on the net The growth in scientific understanding of diseases and their management is unprecedented, but is not matched by an equivalent ability to apply that knowledge in practice. It is now humanly impossible for unaided healthcare professionals to possess all the knowledge needed to consistently deliver patient care with the efficacy and safety potentially made possible by current knowledge. This is a worldwide issue, not just for the troubled NHS. At last year’s meeting we introduced the concept of the “publet” a package of conventional knowledge sources (such as clinical guidelines and care pathways) integrated with point-of-care services for decision support, workflow and resource management, service monitoring, risk assessment and the like. In this talk we provide a progress report on publet technology, and a demonstration of the Tallis authoring and publishing system under development at Cancer Research UK. OpenClinical is an international organisation* that has been created to promote use of decision support, clinical workflow and other advanced knowledge management technologies for patient care and clinical research. The OpenClinical web site (www.openclinical.org) provides a substantial and growing set of resources for anyone wishing to find out more about current developments in the field, including reviews of available technologies and services, tools and demonstrators, and policy discussion papers. OpenClinical is currently sponsoring an international “collaboratory” an experimental study of collaborative preparation and publishing of open source guidelines using Tallis technology. The project and its objectives will be outlined and discussed. * Created and maintained as a public service with financial support from Cancer Research UK under the guidance of an international scientific and technical advisory board (http://www.openclinical.org/scientific_board.html).

CLINICAL PRACTICE & GUIDELINES “Medicine is a humanly impossible task”

BUT … Busy doctors have little time to read Even if they find time, memories are unreliable and working pressures acute Paper guidelines address general principles, not the needs of individual patients.

THE WORK OF THE ACL Supporting health professionals and the NHS cancer plan Improving prevention Cutting waiting times Better detection Improving treatment Better palliative care Empowering the patient Preparing for the genetics revolution

IMPROVING PREVENTION Risk Assessment in Genetics Andrew Coulson, David Glasspool, Jon Emery

CUTTING WAITING TIMES Helping GPs make referrals Jon Bury, Michael Humber

BETTER DETECTION Automated image interpretation Paul Taylor, Margarita Sordo

IMPROVING TREATMENT Leukaemia in children Jon Bury, Chris Hurt Vaskar Saha

IMPROVING TREATMENT Palliative care with InferMed Ltd.

EMPOWERING THE PATIENT Patients “want support in making their own choices about timing, to consider options for treatment … and they want the arrangements to be personalised around their own circumstances and particular clinical needs” David Glasspool, Rachel McCloy Tito Castillo, Vicky Monaghan

CREDO: PUTTING IT ALL TOGETHER