Education And Debate

Hospital information management: the need for clinical leadership

BMJ 1995; 311 doi: (Published 15 July 1995) Cite this as: BMJ 1995;311:175
  1. Jeremy C Wyatta, medical informatics manager
  1. aBiomedical Informatics Unit, Imperial Cancer Research Fund, London WC2A 3PX
  • Accepted 4 July 1995

On 12 July the Audit Commission published For Your Information, a well researched report about information and its management in acute hospitals in Britain, how and why it is failing, and steps that clinicians, managers, and the NHS should take to correct this. This article discusses why information management matters to clinicians and considers the problems identified by the Audit Commission—most of which will strike chords with doctors—and possible remedies. Finally, it decribes possible routes to adminsiter these remedies and the proposal, recently supported by the BMA Council, for a national centre for health informatics with the goals of educating and enthusing clinicians about informatics, empowering them to participate in local and national information management decisions; exploring how information can be used to improve patient care and outcomes; and evaluating clinical information systems and helping to realise their benefits.

Clinical information and its management in hospitals

Although the Audit Commission states that “information is one of the most important resources that a hospital holds,”1 information is also its least tangible resource. Information can be defined only by its function—“organised data or knowledge that provides a basis for decision-making”2—and consists of knowledge about how to achieve a goal and data about the starting point and the intervening terrain. When a clinician takes a patient management decision, these data consist of patient findings (history, observations, and test results), hypotheses (including assessments, such as the referral diagnosis, and plans), and previous actions taken.3 However, when a decision is taken about a group of patients, a clinical service, a purchaser-provider contract, or a health care organisation, data about individual patients must be grouped and abstracted before being combined with data about staffing, facilities, and other resources. Thus, high quality patient data is the foundation for decisions at all levels in a health care system (figure).

Fig 13

Pyramid of …

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