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The need for information to bridge organisational and clinical domains
  1. Tom Smith
  1. Judge Institute of Management Studies, Cambridge University, Cambridge CB2 1AG, UK

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    It has been estimated by the Audit Commission that a quarter of hospital staff time is spent collecting data and using information. Information is a critical daily activity, and is a foundation of efforts to secure improvements in the quality of patient care and safety. But, despite its importance, information is not as well used as it could be in healthcare settings. The papers included in this review suggest we should be concerned at our current capacity to use information to underpin meaningful review and adaptation of practice.

    In 2001 the US Institute of Medicine stated that IT “has barely touched patient care”. It must “if a substantial improvement in quality is to be achieved”. In the UK, Derek Wanless’s review of future trends in health care called for an immediate doubling of expenditure on computing. These heavyweight views add force to existing strategies to promote better use of IT in health care, including a target that all clinicians should have access to electronic patient records by 2008.


    Tim Benson’s two-part discussion of “why general practitioners use computers and hospital doctors do not” is an informative history of the bumpy road to computerisation in the NHS. There are two main reasons for the difference, in Benson’s view: “incentives” and “scalability”.

    During the 1970s there was a lot of experimentation with computing, but by the end of the decade the trend had passed: “Progress ground to a halt”. We may even have gone backwards in some regards. “Today, few English hospitals have integrated patient administration and cumulative clinical laboratory reporting systems accessible from terminals on the wards and in outpatient clinics”. Yet, as long ago as 1975, such facilities were operational in several English hospitals including Charing Cross, the Royal London, and the Queen Elizabeth Medical Centre, Birmingham.

    One of the …

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    • Compiled by Tom Smith