Improving services with informatics toolsBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7526.1190 (Published 17 November 2005) Cite this as: BMJ 2005;331:1190
- Frank Sullivan, NHS Tayside professor of research and development in general practice and primary care,
- Jeremy C Wyatt, professor of health informatics
- University of Dundee
This article describes how many sources of data can be linked, interpreted, and analysed before being presented to decision makers to improve care. It also discusses the legal issues surrounding data protection and freedom of information.
A huge volume of data flows across the desk of a director of public health (see box opposite). One of the director's problems is to know which signals to act upon and what “noise” to ignore. If the numbers being considered are small, as they probably will be in the case described here, a critical incident analysis may be all that is needed. An individual prescriber, or group, may have an erroneous belief or inadequate training. Critical incidents or other signals often indicate that more data (such as data on prescribing steroids for paediatric asthma in primary care and outpatients) are needed.
Sources of data
Health services are awash with data. Earlier articles in the series described the large and increasing numbers of sources of data available to consumers, patients, clinicians, and administrators. Clinicians, teams, divisions, and other groups collect the data they need to carry out their work, and they may do so using coding and terms that others can understand and share. The intensive care unit in this example integrated the data the team needs to manage patients during their stay with patients' pre-admission prescribing data. This local epidemiology may have been done as part of clinical governance activities, or as an ad hoc exercise when a patient's problem was investigated.
One difficulty with secondary uses of clinical data is that, having obtained the data indicating a problem exists, the issue must be dealt with effectively. It may be that the individual or group who identify the problem have the knowledge, skills, and resources to resolve it. In other cases, such as these potentially …