Chief clinical information officers: clinical leadership for a digital ageBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3295 (Published 10 July 2017) Cite this as: BMJ 2017;358:j3295
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Sood et al argue for clinical informatics leaders in NHS organisations to accelerate the development of digitally-enhanced models of care. We argue that safe and effective clinical pathways redesign and better use of health data requires not just digital leadership, but also academic involvement. Researchers are needed to generate and publish robust evidence on the benefits and harms of digitally-enhanced service models. Rigorous analyses of healthcare databases require expertise in data science, statistics, and knowledge of front-line services, all best provided in a team with safe and accountable access to data. Without early involvement of researchers in the design of pathways, results can be powerfully wrong, and care can be misdirected or harmful. Witness the warnings about the potential harms of risk stratification, but such practice continues, directed by algorithms, untouched by frontline clinicians and mostly unevaluated by researchers.
Academic researchers are currently held back from contributing to clinical redesign by unreasonable obstacles to data access. Whilst NHS England has streamlined data access to local authorities and commissioners,[3,4] researchers are left behind, jumping through the hoops of data applications, while witnessing shortcomings in the design and evaluation of new services. Simultaneously, a minority of NHS data releases go to commercial companies who perform analytics for multiple clients, including NHS bodies. There are few incentives or resources for these users to document and publish how data are being used, let alone share their algorithms and build a knowledge base of methods and expertise. The risk is that patients, clinicians, and service providers may not be aware of, let alone be able to explain, how healthcare data is changing care. Without wider and more timely use of health data for research, the social contract with patients, to use health data for public benefit, risks being undermined.
Ruth Gilbert, professor of clinical epidemiology, Peter Dutey-Magni, Research Associate, Administrative Data Research Centre for England, University College London
1.Sood H, NcNeil K, Keogh B. Chief clinical information officers: clinical leadership for a digital age BMJ 2017; 358 :j3295. doi: https://doi.org/10.1136/bmj.j3295
2. Lewis HL. Next Steps for Risk Stratification in the NHS. NHS England Discussion paper 2015. Available from: https://www.england.nhs.uk/wp-content/uploads/2015/01/nxt-steps-risk-str...
3. NHS England. Data Services for Commissioners (DSfC) FAQs [cited 2017 Jul 20]. Available from: https://www.england.nhs.uk/ourwork/tsd/data-services/faqs/
4. NHS Digital. Local Authority HES Extract Service [cited 2017 Jul 20]. Available from: http://content.digital.nhs.uk/hesextract
5. NHS Digital. Registers of approved data releases [cited 2017 Jul 20]. Available from: http://content.digital.nhs.uk/dataregister
Competing interests: No competing interests