1. ©2002 Sowerby Centre for Health Informatics at Newcastle The National Perspective ICRS The Durham & Darlington Approach Where to Start? Ian Purves ?

2. ©2002 Sowerby Centre for Health Informatics at Newcastle

3. “If history repeats itself, and the unexpected always happens, how incapable must Man be of learning from experience.” GB Shaw (1856 - 1950)

4. ©2002 Sowerby Centre for Health Informatics at Newcastle Problem Analyst Solution Specifier Solution Designer Problem Owner Concepts Formalisms Programmes Mappings Rhetorics Natural language and “rich pictures” Conceptual models Formal Representations Interpretations of calculi, transformations, or traces. Assignments of mappings and referents Implementer

7. ©2002 Sowerby Centre for Health Informatics at Newcastle What are the issues? Sectors and boundaries … No 10 NHS IA StHA Acute Trust Mental Health Trusts Community and Social Service Trusts PCTs GP Practices Patients Understanding sectoral fragmentation Provision of practical steerage and guidance Duality of accountability  No 10  Patients

8. ©2002 Sowerby Centre for Health Informatics at Newcastle Where to start? … at home … Developing real clinical benefit from Informatics

9. ©2002 Sowerby Centre for Health Informatics at Newcastle You are here

10. ©2002 Sowerby Centre for Health Informatics at Newcastle What are the issues? Sectors and boundaries … ‘Legacy’ Incumbent systems Available functionality Available infrastructure Natural clinical workgroups and governance arrangements Understanding the role of national strategy Utilising national technical standards

11. ©2002 Sowerby Centre for Health Informatics at Newcastle Solution … Local Processes Understanding the clinical needs Understand and empower ‘legacy’ capacity Developing the business plan Programme & project management Education and training Feedback to the centre

12. ©2002 Sowerby Centre for Health Informatics at Newcastle How to begin to start? In our area building on DuDEHR Utilising our methods Utilising developed communities New project to further refine … Communities and their capacities Federation between communities Local supportive development centre (e.g. ethnography, project management …) Evolution of different system architecture projections

13. ©2002 Sowerby Centre for Health Informatics at Newcastle How to begin to start? … in your area? … … nationally? … “The future belongs to the unreasonable man who looks forward, not back, who thinks the unthinkable and who is certain only of uncertainty.” GB Shaw “Introducing new material via a lecture may be a very effective teaching method, but it is mostly a very ineffective learning method.” Uri Leron and Ed Dubinsky