Review of e Clinical Governance: A Guide for Primary Care
Louise Simpson, Paul Robinson, eds. Abingdon, Oxon: Radcliffe Medical Press, 2002. £19.95. 128 pp. ISBN 1 85775 595 2.
Unlike elephants, clinical governance is easy to describe in theory but hard to know if you have a splendid example in front of you. This book, which introduces the reader to the field of health informatics, helps this process of turning clinical governance from rhetoric to reality. Health informatics is more than just using a computer in a clinic or surgery. It is, the editors tell us, a “scientific approach to information, which includes how we think, how data become information and knowledge, how we communicate in clinical practice, how we represent data, information and knowledge in computers, how we learn, how computers can support clinical practice”. It is this staggeringly wide definition that provides the clue to the book’s strength and weakness. It scopes the field of health informatics competently, urging the reader and all healthcare professionals to record clinical data more accurately, use it more fruitfully, and reflect on it as part of continuing personal and professional development. The book deals with the practical aspects of this challenge adequately. The authors advocate using Prodigy, unsurprisingly, as a number of the contributers have helped develop that programme. They explain the use and availability of Prodigy well, and signpost the reader to a host of useful websites for clinical guidelines, protocols, and other evidence based centres and groups. And they explain clearly the contribution of Read codes, and the value of the PRIMIS and MIQUEST programmes in organising and retrieving clinical data. But the book has taken on this huge brief—outlined in its definition–and doesn’t deal with the theory underpinning health informatics robustly. The authors never really nail the connection between clinical governance and health informatics, and provide somewhat bland sections on risk management and the theory of knowledge. They do stray occasionally into the odd platitude, and stand accused, like many others, of misusing the word “paradigm”. But this is essentially an introductory guide, a practical book to help people navigate through a tricky and increasingly important field, as shown by the final section which is full of practical advice on education. Readers who seek that level of information won’t be disappointed.