In a 'paperless NHS' - let's not forget...

The benefits of information technology across all sectors are well recognised when they are realised:

individual
INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

creativity usability readiness to hand context	information storage and retrieval, access, efficiency, space, security, information sharing, patient safety, legibility
digital inclusion	cost, savings, governance, reporting (locally, nationally, internationally), policy integration

As we head towards a paperless NHS let's not forget that health care is both an art and a science.

Links:

The Digital Challenge (due for an update?)

Digitising the NHS by 2018 - One Year On. techUK report | March 2014.

What of the impact of the pending election 2015? Time inconsistency problem:
The NHS needs a 'Bank of England moment' HSJ.

drawMD Pediatrics - Patient Education by Drawing on Medical Artwork for Healthcare Providers

Medical-Artist

Two-day symposium ‘Concerning Relations: Sociologies of Conduct, Care and Affect’ 28-29 Nov. 2014

We are pleased to announce a two-day symposium ‘Concerning Relations: Sociologies of Conduct, Care and Affect’, 28/29 Nov. 2014, University of Exeter. The aim of this exciting international workshop is to bring together leading researchers, practitioners and scholars from care studies, sociology of health and illness, science and technology studies, humanities and philosophy to rethink care. We also plan to publish the results of the workshop.

This interdisciplinary symposium, funded by Foundation for the Sociology of Health and Illness (FSHI) and Exeter University, aims to interrogate the implications of shifting the focus of health care away from ‘delivery’ towards care as an ongoing everyday accomplishment. The situatedness of care relations and how situated care relations are practiced and experienced are vital to understanding the impacts care has upon patients, families and healthcare staff. This shift represents a contrasting view on care, from one that is predicated upon a discourse of absence (of care) or lack (of dignity) to the affective interactional relations between social actors. Such shifts of focus are of prime concern as care may be viewed less as a commodity which can be lost, saved, traded or withheld, but as a relation that is deeply embedded within institutional contexts, of individuals and the social worlds they inhabit.

This symposium examines spaces of collisions, elisions or alignments of social worlds, within which the affective dimension of social life in healthcare may be fruitfully examined. Drawing upon relational concerns as a distinct and distinctive mode of sociological inquiry, the symposium seeks to develop an understanding of care and its consequences that help us get beyond the economics of care as a commodified and managed form of engagement with the ‘other’. Making this shift has huge potential for addressing long-standing, global concerns around ‘cultures of poor care’ or ‘care as absence’, the seemingly intractable problems that are not readily amenable to a quick or even a slow fix.

The symposium examines how the fix, the cure, remains an issue of perspective. Central questions include:

• What if the ‘problem’ of caring in health care settings was viewed differently, how would the issues be seen through an affective, situated relational perspective, how would an affective orientation resolve or heighten long standing and seemingly intractable problems of institutional care?
• Is the demand for a cure (the fix) a manifestation of a broader political economy at work, is it a question of the mundane interaction order where contemporary modes of conduct reinforces distance, or is the organisational ‘cure’ simply a manifestation of organisational disease?
• Can materials, economies, institutional practices and modes of accounting contribute to poor clinical and managerial conduct and do such devices legitimate a focus away from the patient?

Rather than provide a critique with no visible solution, or provide a simplification of institutional mores, a more cogent question may be what or who is now being cared for. Once such questions of central importance to a relational sociology have been attended to, the case for re-imagining the organization of care as a situated accomplishment can be made, a case based upon sound sociological reasoning. This symposium challenges what it means to care.

The organizers would appreciate general information about your possible participation before 15.07.2014. Please reply to: m.schillmeier AT exeter.ac.uk

Kind regards

Michael Schillmeier (Exeter)
Joanna Latimer (Cardiff)
Paul White (Swansea)
Alexandra Hillman (Cardiff)
----------------------
Professor Michael Schillmeier
Schumpeter Fellow / VolkswagenStiftung
Department of Sociology, Philosophy and Anthropology
Centre for the Studies of Life Sciences
Byrne House
University of Exeter
Exeter EX4 4PJ

New Nuevo Neu
Eventful Bodies: The Cosmopolitics of Illness. Ashgate (forthcoming)

http://www.nanomedizin.soziologie.uni-muenchen.de

For portals, speak patients' language ( c/o Healthcare IT News )

Mike Miliard's 

For portals, speak patients' language 

in Healthcare IT News is a reminder of accessibility and engagement at the level of a communities languages.

This is one of the reasons why I am committed to using Drupal, to try to make use of its Internationalization capabilities amongst others. 

Thanks to Mike's post I'm now familiar with a 'full court press' as a hospital - enterprise wide no less - seeks to achieve defined patient engagement levels by accessing their electronic health record.

This begs the question of what constitutes the patients' language? I don't just mean the purely linguistic forms of Chinese, Korean, Russian and Greek mentioned in the article. The effort is driven by the statutory demands of meaningful use, but what of the patient's general literacy, IT and health literacies? How do patients make sense of their own health (or another in the role of a carer) not just in a given language, but culturally from a medical sociological and public health perspective? What is the community's vocabulary when it comes to health?

How can we assure that meaningfulness? How can we affirm that use and critically translate use into patient benefits and self-efficacy?

You could also entitle Mike's article as

4 portals speak patients' language

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

Health Literacy, Accessibility	Measures (health literacy, patient engagement, health and well-being, clinical outcomes)
Cultural Diversity, Languages, Carer	Internationalization 'Meaningful Use', Standards, Legislation, Policy

When we focus on languages we must remember that listening is a great gift. Whether as health and IT professionals, educators, patients and carers, listening to the care domains can help us integrate diverse social, clinical, policy and technical objectives.

What do these portals say to you?

Mike Miliard twitter

Help Doctoori.net deliver Health Information For All

Doctoori brings to you, high quality, reliable health information in the Arabic language, through our syndicated partnership with NHS Choices. Our engaging, patient focused articles and interactive tools provide an invaluable, trusted health resource for you and your family. 

Doctoori is more than just a website. Whether you want advice on how to get fit, which super foods actually boost your health, or a guide to your pregnancy and keeping your baby healthy, we have it covered. Also if you need to see a clinician face-to-face, our find a clinic healthcare directory will give you the information you need to choose who is best for you.

Our UK based editorial team ensure all our articles are:

• Based on the latest medical evidence
• Rigorously reviewed
• Thoroughly monitored to ensure they are up to date
• In keeping with the high standards set by the Information Standard.

Doctoori.net

 ..... with you on your journey to better health

My source: Zain Sikafi CEO and Founder of doctoori.net  - info AT doctoori.net

12th May Lancaster, Workshop: Patient knowledge and involvement in healthcare

An event I am looking forward to: 

Royal Institute of Philosophy Workshop
Storey Institute, Lancaster
Monday 12th May

In recent years great efforts have been made to listen to “patient voices” in healthcare practice, research, and policy, but such initiatives have met with mixed success and many patients continue to feel that their view are overlooked (sometimes despite the best efforts of health care professionals). In this workshop we consider whether and why patient views matter. We ask what factors act to limit the possibilities for communication between patients and professionals, and consider how they might be overcome.

• 10-10.40 Chaos, conflict and cooperation. Havi Carel, Senior Lecturer in Philosophy, Bristol University
• 10.40-11.20 Silencing the sick. Ian J. Kidd, Addison Wheeler Fellow in Philosophy, Durham University
• 11.50-12.30 On trusting and being trusted. Garrath Williams, Senior Lecturer in Philosophy, Lancaster University
• 2-2.40 Patient advocacy challenged: The case of ME/CFS. Nancy Blake, Patient activist and PhD candidate, Lancaster University
• 2.40- 3.20 Medical paternalism and the right not to know. Emma Bullock, Postdoctoral Fellow “Concepts of Health”, King’s College London
• 3.50-4.30 Negotiating as individuals and groups. Rachel Cooper, Senior Lecturer in Philosophy, Lancaster University

Organisers: Ian J. Kidd and Rachel Cooper

Free and open to all, but numbers are limited. To reserve a place please email
Rachel Cooper - on r.v.cooper AT lancaster.ac.uk

Informatics in Primary Care - journal

Informatics in Primary Care Journal

On Wednesday I visited HC2014. Having the week off and with the event literally on the doorstep (London in 2015) it was very convenient.

I'd received an email the evening before on the new informatics federation and heard the official announcement in the opening session. My last HC event was 2005, my first 1986 also in Manchester if I remember correctly.

I posted the federation news this morning. On the BCS stand I picked up a copy of the INFORMATICS IN PRIMARY CARE.

This journal is open access. Despite the title and perhaps illustrative of the dependencies within and need to integrate health (and social care) the journal's coverage is broad and inclusive:

We are interested in how computerised medical records can better record the clinical status of patients and can be used to measure the quality, safety and efficiency of health care professionals and organisations – including primary care, hospital, mental health, and social and community care.  The scope of the journal also includes integrated care and how genetic data might be used to enhance health care.

I will reflect a little more on HC2014 soon.

Five Days at Memorial by Sheri Fink: Book

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

Five Days at Memorial by Sheri Fink

group - population

Five Days at Memorial by Sheri Fink: The Indepedent - Review

Image source: http://www.barnesandnoble.com/w/five-days-at-memorial-sheri-fink/1114975091?ean=9780804128094

Better information means better care

BBC Radio 4: Inside Health 21 January 2013

Margaret McCartney and Mark Porter ask whether the anonymity of patient records on a new NHS database can be guaranteed?

NHS: Your records:

Using information about the care you have received, enables those involved in providing care and health services to improve the quality of care and health services for all. The role of the Health and Social Care Information Centre (HSCIC) is to ensure that high quality information is used appropriately to improve patient care. 

NHS England has therefore commissioned a programme of work on behalf of the NHS, public health and social care services to address gaps in information. Our aim is to ensure that the best possible evidence is available to improve the quality of care for all.  ...

http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Pages/care-data.aspx

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

my interests	scientific interests
social interests	commercial interests

group - population

Resistence is futile: give in to the obvious need for the 'nhm'

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

nhm	ohm + nhm
nhm	nhm (+ ohm!)

group - population

ohm: The ohm (symbol: Ω) is the SI derived unit of electrical resistance, named after German physicist Georg Simon Ohm. (Wikipedia)


nhm: The nhm (symbol: +).

However, the principles do not extend to problems posed by cognitive impairment as a result of the illness and the ever present danger of wandering, seeking old and familiar surroundings, or acting on memories from years gone by. Some patients become aggressive at times; the service must have mechanisms for managing patients effectively in ways that recognise their inherent worth and humanity. The stigma and abbreviated autonomy that is implied in managing people with dementia requires a new holistic method of managing their care that relates the care to the patients'/service users' values. p.80. [my emphasis]

Heginbotham, C. (2012) Values-Based Commissioning of Health and Social Care, Cambridge, CUP. (Review to follow).

TO: EU -omics research community; if you are seeking a holistic approach for personalised medicine...

The relevance of Hodges' model as a resource in 21st century health care and research can be found within personalised medicine.

This is in addition to the need to assure holistic bandwidth within existing health care delivery, when it is person centered care that is the concern. Personalised medicine brings with it further challenges as it emphasizes the scientific, the inevitable reductionist work can potentially increase the distance between the humanistic and the mechanistic. The working document from the European Commission -

Brussels, 25.10.2013 SWD(2013) 436 final COMMISSION STAFF WORKING DOCUMENT. Use of '-omics' technologies in the development of personalised medicine
http://ec.europa.eu/health/files/latest_news/2013-10_personalised_medicine_en.pdf

on page 7 we read:

The figure is instructive as it shows that a holistic approach is needed to fully appreciate the challenges and opportunities presented by personalised medicine. 

'Holistic' is a much maligned word, with its fuzzy, new age connotations. Especially when the word count = '1'. Another related document also picks up the holistic call:

IMI2 will deliver tools, methods and prevention and treatment options (directly or indirectly) that will progress the vision of personalised medicine and prevention. Through providing the framework required to support collaboration between scientists, regulators, HTAs, patients and healthcare providers, IMI2 will ensure that research is translated into implementable solutions to current healthcare challenges. Solutions that are not purely focussed on the development of new medicines, but that provide a holistic personalised healthcare package as well as maintain people healthy and productive through out their lifetime. Reclassification of diseases based on their root cause and not symptoms will help addressing unmet needs even in areas where a range of options exist but patients do not respond, because their symptoms are misleading therapy choices.
[ IMI - Innovative Medicines Initiative ]

Outline Strategic Research Agenda for a biomedical research public private partnership under Horizon 2020: (draft) The right prevention and treatment for the right patient at the right time. 08 July 2013http://www.efpia.eu/uploads/Modules/MCMedias/1373296554546/IMI2%20Strategic_Research_Agenda_v%208%20July%202013.pdf

On page 10:

A sustainable healthcare system is a holistic one in which the patients are responsible for their wellness and quality of life; physicians, therapists, nutritionists, community carers, and all other actors in the value chain are motivated to this goal; delivery of care takes into account patient beliefs, values and both rational and irrational behaviors; the care is affordable to both public and private payers and promotes health; sustainable businesses can thrive; and the education, prevention and management of chronic conditions are aligned to achieve this goal.

The focus of these documents is -omics and the development of new medicines. By its very nature this research, data and knowledge lies deep within many sciences: new sciences no less. This recognition of the need for holistic approaches and perspectives is still very encouraging. As the first document on personalised medicine notes, future treatments must be from "bench to bedside". We can equate this as "mechanistic to humanistic", but only as long as the patient in that bed is a person and not just viewed as a diagnosis with an associated -omic profile.

Have a look also at the figure on page 7, the medical innovation cycle. As discussed previously on W2tQ patient safety needs situated awareness and holistic perspectives.

My original (and seemingly incomplete) source:
http://www.researchresearch.com/index.php?option=com_news&template=rr_2col&view=article&articleId=1339313

Health 2.0 Europe 2013: Nurses, registration and £££

This year I've really enjoyed the Health 2.0 Manchester chapter meetings and there's some great evening sessions to follow this northern autumn. In June as I posted on W2tQ I also spent a weekend at the NW Health Hack in Knutsford. 

For several months European Health 2.0 conference has been publicized at the Manchester meetings. I was keen to attend until I saw the registration fee even with a 15% reduction. The fee increased yesterday too as I was reminded by Pascal Lardier on twitter:

@pascal_lardier 19 Sep
Today is the last day to pay less for your ticket to @Health2eu Register here: http://www.health2con.com/events/health-2-0-europe-2013-registration/ … #health2con #nhssm #hcsmeu

I retweeted the above and replied to Pascal and Health2eu, telling them what they already know - Health 2.0 rocks! but adding that I thought few nurses would be able to afford the registration fee.

NW Health Hack was a success for me (in addition to our group coming 3rd) because it was free, apart that is from driving there over the weekend on my days off (thanks again to all the sponsors). As the NHS is trying to save money I've also taken some unpaid leave this year.

NHS nurses, like many public sector groups have effectively had a pay cut these past few years. There are other general challenges:

• Are those nurses who might attend already 'onboard'?
• Does nursing engagement itself need a health check (what is 'clinical engagement' now)?
• Much was made of achieving clinical engagement in previous NHS IT projects. How can clinical engagement that reaches nurses be assured now?
• If (technical) innovation is to be a constant stream, please don't leave the nurses on an island: they can set sail too.
• Are nurses, like the one writing this, tainted, having been sat on the fence (health care || ICT) for too long?
• Once projects are established how can nurses, patients and carers stay the course and keep in touch and engaged?
• As 'NHS clinicians' can nurses participate in initiatives such as the forthcoming Code4Health, or will operational constraints limit their involvement?
• How are the socio-technical aspects and outcomes measured (hospital vs. home personal use vs. self-care...) ?
• Is there a golden ratio for the mix of delegates?
• If there's a strategic partner involved where's the strategy?

Pascal sliced through my query and many of the points above:

Pascal Lardier ‏@pascal_lardier 19 Sep
- then they should reach out to me!

So if the World Wide Health 2.0 conferences are of interest to you, do as Pascal suggests. New communities can provide new opportunities. Don't just help make your day, help make tomorrow too.

In 2012 the NHS employed 146,075 doctors, 369,868 qualified nursing staff, and 37,314 managers. 
http://www.nhsconfed.org/priorities/political-engagement/Pages/NHS-statistics.aspx#staff

Additional notes 29 Sept:

Health 2.0 MCR ‏@H20MCR

@h2cm patients are also asking how can @Health2eu Health 2.0 Europe conference be made more accessible for them @pascal_lardier?

Pascal Lardier ‏@pascal_lardier

@H20MCR @h2cm @Health2eu @pascal_lardier they should email me pascal AT health2con.com there is a FREE reg code for them.

The Case for Information: Investment in patient information improves outcomes and reduces costs

A new Patient Information Forum (PiF) research report highlights how providing information to patients and their carers improves outcomes, reduces costs and gives people a better experience of care.

PiF commissioned research to identify the benefits of investing in health information. The project, which looked at over 300 studies, found that there are good business reasons to justify the investment of more time, money and training in health information provision and support. These include positive impacts on service use and costs, substantial capacity savings, and significant returns on investment by increasing shared decision-making, self-care and the self-management of long-term conditions.

To access the report please see:
http://www.pifonline.org.uk/the-case-for-information-investment-in-patient-information-improves-outcomes-and-reduces-costs/

My source: Irina Johnston, CHAIN Administrative Assistant

Mental Health at NWHealthHack Knutsford - Prof. Lewis (thanks)

NWHealthHack began with several briefings. These were all excellent in providing both technical and health care insights before projects were pitched in 60 seconds.

Prof. Shôn Lewis set the health agenda in the context of mental health. I'm really grateful to Prof. Lewis to be able to share two slides here. The first speaks volumes not only in the research spend across health care domains but the disability-adjusted life year (DALY):

Over the past 25+ years I'm aware of the change within community mental health nursing. I can summarise this as follows:

• 1985 one of six new community psychiatric nurses - CPNs
• Early 1990s newly built community mental health resource centers
• Mid-late 1990s CPNs criticised for not meeting the needs of the enduring mentally ill
• Early 2000s early intervention services, role of psychosocial interventions
• Mid-late 2000s reduction and closure of mental health day hospitals
• Early 2010s former community mental health resource centers turned to primary care (mental health)

I have mentioned here previously about the need to put the 'mental'' into public - health and the need to put mental health literacy on the map. It will be interesting to watch what happens now that this has landed in a very 'local' way within Local Authorities. Prof. Lewis reviewed the situation in mental health conjoining serious mental illness, services and self-care, making a critical point for those readers working in community mental health teams. This should also give pause for thought for those (like me) working in related services:

Prof. Lewis also shared an app - ClinTouch and reflections on the professional's response to the apps potential and the findings in practice. It's never easy being open to what is new and being ready as a consequence to re-invent yourself. If that's a problem for individuals then for professional groups and multidisciplinary teams it's an even greater challenge. ...

Government steps in to settle medical dispute over digital patient records - Canada

REGINA - The Saskatchewan government has stepped in to help three Regina doctors who were having problems getting their patients' digital medical records from the clinic where they used to work.

The office manager at the Gateway Alliance Medical Clinic says efforts to get the electronic records from the Midway Walk-in Healthcare Centre had been ongoing for two months.

Robin Anderson says Midway transferred paper files as required by Saskatchewan law, but not the digital records.

http://bit.ly/14xRYgS

My source: Peter Kurilecz - Records Management List

Information and Records Management Society

"How to Avoid Mistakes in Surgery" BBC TV Horizon 21/03/2013 2100 UT

On 03/18/13 9:45 AM, Martin Bromiley wrote:
--------------------
About two years ago I approached Dr Kevin Fong with an idea for a BBC scientific programme, and at last it’s happened. Since September I’ve been working with Kevin and the BBC Horizon team to pull together a programme about human factors in healthcare. It looks at how learning about the human in the system and the system itself can bring about enormous improvements in safety and outcomes that technology and medical science can only aspire to.

Kevin and the Horizon team have produced something inspirational yet scientific, and - just as importantly - is by a clinician, for clinicians. It's written in a way that will appeal to both those in healthcare and the public. It uses a tragic death to highlight human factors that all of us are prone to, and looks at how we can learn from others both in and outside healthcare to make a real difference in the future.

Although the BBC Management chose a surgery based title for the programme to gain mass public appeal the lessons of this programme are for everyone in healthcare.

It would wonderful if you could pass on details of the programme to anyone you know who works in healthcare. My goal is that by the end of this week, every one of the 1 million or so people who work in healthcare in the UK will be able to watch it (whether on Thursday or on iPlayer). BBC 2 Thursday 21 March 2100 UK

Cheers

Martin Bromiley

My source: Joy Whitlock via LinkedIn

Piloting (online) health literacy - 'easy as she goes?'

On Thursday afternoon I introduced Hodges' model to six student nurses. In wrapping up the session I suggested the students look up 'health literacy' indicating how Hodges' model can incorporate reflections on the many literacies essential for life (and death) in the 21st century. For one student this small kernel of news was unfortunately too late, a piece of work having just been handed in.

Great to see the following item in this week's HSJ - Health literacy training on offer for 100,000:

The NHS Commissioning Board will work with a charity to offer 100,000 people access to training in online health literacy over the next year, it has announced.

The board’s national director for patients and information Tim Kelsey said on Thursday it had made the agreement with UK Online Centres, an organisation which specialises in tackling digital exclusion.
The work comes in the run up to the board’s deadline of 2015 for patients to have access to their GP health records. ...

Health literacy training on offer for 100,000, Health Service Journal. 14 March 2013, p.10.

In terms of health literacy as a whole this is one aspect, but as the previous post point out we need to consider human factors. Innovation  also involves physical and cognitive access, relationships, referral, the interplay and dependencies between existing literacies (poor functional literacy and yet high health literacy?), differentiating between literacies, motivations and to what extent can participants themselves be mobilised as a force for change beyond 100,000 ...?

The Telehealth supplement in the same issue of HSJ notes that small companies struggle when they are offered yet more pilot projects with 30 patients.

100,000 - well that should be a good shot in the arm.

Trueland, J. (2013) The six billion dollar question, Telehealth supplement. HSJ, 14 March, 8-9.

Additional link:
http://www.hsj.co.uk/news/commissioning/kelsey-plans-action-on-health-technology-education/5055974.article

Southern Institute for Health Informatics 2013 Annual Conference 11 September 2013, Portsmouth, UK

The annual SIHI conference will be held in Portsmouth on Wednesday 11 September and we invite you to participate. 

The conference theme this year is the challenging question: 

“From ‘Big Data’ to Collective Wisdom?” 

The programme will address a range of topics related to how information can change practice and culture in health and social care. Why is there such tolerance of unsafe processes in the NHS? Will information transparency help to break down a bullying culture where it persists? Why is there still such an information gulf between care sectors? Can operational care data reliably guide individual patient management and service commissioning? Is the latest ‘paperless NHS’ aspiration achievable and, if so, how?

Fundamentally we are asking what is happening to the ‘wisdom quotient’ of health and social care and looking at inspiring examples of excellence.

The programme will feature keynote speakers and a range of invited and submitted presentations. In addition, the “Infomart”, an informal information marketplace area, will allow vendors and researchers to set out a stall to meet people and exchange information.

If you would be interested in contributing to the programme or if you have an idea you would like to discuss, please email us at SIHI at port.ac.uk. Proposals for presentations should be accompanied by a 100-150 word outline, and will be considered until the programme is finalised. The SIHI 2013 conference website is at www.port.ac.uk/sihi

Manet & the art of nursing - never unresolved: (and The Francis report)

Yesterday I travelled to London for a nurse related meeting and used the opportunity from 8pm - 11pm to take in the Manet exhibition at the Royal Academy of Arts. Brilliant! It is a great event. There really is no comparison apart from the very high resolution close examination that our technology makes possible; but then that is a difference experience, a different purpose.

Manet's work at the RA includes paintings that do appear unfinished. Areas of the canvas being unresolved brings home the relationship and dependency of the artist with the subject, and the artist's approach to portraiture. Manet was quite demanding on his subjects apparently and while not completely averse, he did not routinely rely on the new opportunities that photography afforded. Here are some thoughts from the Art Fund website:

'Summer' or 'The Amazon', by Edouard Manet

Manet was a great risk-taker and critics of day rallied against his inconsistent approach, as you will see many of the works seem 'unresolved' or 'unfinished' but one of Manet's great skills was this ability to stop painting at the right moment, and it is this technique which gives the works a sense of movement and life.

Manet once said to his friend Antonin Proust, 'I must be seen whole. Don't let me go piecemeal into the public collections; I would not be fairly judged.' This exhibition, which brings together the largest selection of works by the artist to be exhibited together in a UK museum, is a great opportunity to judge Manet's extraordinary talent as a 'whole'.

In nursing we are accustomed to impatient patients. Many though have no choice but to 'sit' and 'lie'. They are static, not able to walk or run away.

Unconscious patients - we speak to them: redrawing the outlines. Searching verbally where we cannot go, reaching for the centers of personhood. We sculpt them back to their optimal health. Sometimes the brush strokes are urgent, sometimes we improvise with touch.

All the time an ideal: a portrait of care. No matter how busy we are basic nursing care should never remain unresolved.

That part of the canvas is always completed. The outline is integrated. The horizon, foreground, middle and background may be sketchy in the extreme cases, but the real mission critical bases are covered.

What we should never countenance, collude, or indirectly sanction are the cutting of those bases.

If we do the work of art is not just unfinished: it is corrupt.

The Francis Report

Anagram graphic c/o Wordsmith

Manet's 'The Amazon' from: Reproarte.com

Extrasolar planets, x-phi and The Francis report

I'm sure there is a planet out there - extrasolar - with the physical make-up such that be it an incredible water fall, tidal surge, or rolling polished mega-rocks - the noise, could we hear it, would do far more than make your ears bleed.

Today, here in England there is a legal, health and political media event of very serious import. The ruckus in health and political circles might also make for more than bleeding noses and definitely thousands of continuing broken hearts.

The Francis report will be published today. Further insights and findings will be revealed c/o the Public Inquiry with recommendations on the Mid Staffordshire NHS Foundation Trust health care debacle.

In Philosophy Now Jan/Feb 2013 Tibor Fischer's editorial mentions the need for marketing within philosophy and literature, with the suggestion of placing x-phi on a T-shirt.

'X-phi' of course reads as experimental philosophy.

In health care, nursing and social care evidence counts for everything (and for h2cm too). Evidence based practice that is founded upon research is essential. Experiments are needed that can be reproduced, extended, validated. ...

Today is a profoundly sad day for everyone in the NHS, as many commentators have already predicted. The future constantly beckons, but today reflect we must that in the clamour for evidence based care, does this mean we must don T-shirts?:

x-care

Have we forgotten the principles of what it is to care: compassion - our duty of care?

No, but amid the cacophony of technology, technical care, the targets, statistics, budget cuts, the challenges to morale and nursing's values we need to be ever more vigilant.

We must learn how to x-listen and x-shout in the 21st century health care environment(s).

But experiments in how to listen, how to blow a whistle? Surely not.

Well yes: as clearly here basic care systems did not work they failed terribly: individually, organisationally and across the FIVE care domains of h2cm.

International Workshop on Knowledge Representation for Health Care (KRH4C'13) & Process-oriented Information Systems in Healthcare (ProHealth’13)

Call for Papers

5^th International Workshop on Knowledge Representation for Health Care (KRH4C'13)

+

6^th International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’13)

Organized as One Full Day Workshop

Acronym: KR4HC’13 / ProHealth’13

Murcia, Spain –  June 1^st, 2013

In conjunction with the 14th Conference on
Artificial Intelligence in Medicine (AIME'13)

Web site: http://banzai-deim.urv.net/events/KR4HC-ProHealth-2013/

Important Dates

Deadline for workshop paper submissions: 8 March 2013
Notification of Acceptance: 9 April 2013
Camera-ready version: 7 May 2013
KR4HC/ProHealth Workshop: 1 June 2013

Workshop Goals

Healthcare organizations are facing the challenge of delivering high quality services to their patients at affordable costs. These challenges become more prominent with the growth in the aging population with chronic diseases and the rise of healthcare costs. High degree of specialization of medical disciplines, huge amounts of medical knowledge and patient data to be consulted in order to provide evidence-based recommendations, and the need for personalized healthcare are prevalent trends in this information-intensive domain. The emerging situation necessitates computer-based support of healthcare process & knowledge management as well as clinical decision-making.

This workshop brings together researchers from two communities who have been addressing these challenges from two different perspectives. The knowledge-representation for healthcare community, which is part of the larger medical informatics community, has been focusing on knowledge representation and reasoning to support knowledge management and clinical decision-making. This community has been developing efficient representations, technologies, and tools for integrating all the important elements that health care providers work with: Electronic Medical Records (EMRs) and healthcare information systems, clinical practice guidelines, and standardized medical vocabularies. The process-oriented information systems in healthcare community, which is part of the larger business process management (BPM) community, has been studying ways to adopt BPM technology in order to provide effective solutions for healthcare process management. BPM technology has been successfully used in other sectors for establishing process-aware enterprise information systems (vs. collections of stand-alone systems for different departments in the organization). Adopting BPM technology in the healthcare sector is starting to address some of the unique characteristics of healthcare processes, including their high degree of flexibility, the integration with EMRs and shared semantics of healthcare domain concepts, and the need for tight cooperation and communication among medical care teams.

This joint workshop brings together two approaches: healthcare process support, as addressed in previous ProHealth workshops, and healthcare knowledge representation as dealt with in previous KR4HC workshops. The workshop shall elaborate both the potential and the limitations of the two approaches for supporting healthcare process & healthcare knowledge management as well as clinical decision-making. It shall further provide a forum wherein challenges, paradigms, and tools for optimized knowledge-based clinical process support can be debated. We want to bring together researchers and practitioners from these different, yet similar fields to improve the understanding of domain specific requirements, methods and theories, tools and techniques, and the gaps between IT support and healthcare processes yet to be closed. This forum also provides an opportunity to explore how the approaches from the two communities could be better integrated.

History of the Joint Workshop 

Providing computer-based support in healthcare is a topic that has been picking up speed for more than two decades. We are witnessing a plethora of different workshops devoted to various topics involving computer applications for healthcare. Our goal has been to try to join forces with other communities in order to learn from each other, advance science, and create a stronger and larger community. In 2012, the two workshops, KR4HC and ProHealth held a joint workshop, which proved to be very successful. This year, we are aiming to continue the collaboration initiative and hold another joint workshop.

The two workshops have quite a long history, as briefly described below.

The first KR4HC workshop, held in conjunction with the 12th Artificial Intelligence in Medicine conference (AIME'09), brought together members of two existing communities: the clinical guidelines and protocols community, who held a line of four workshops (European Workshop on Computerized Guidelines and Protocols (CPG'2000, CPG'2004); AI Techniques in Health Care: Evidence-based Guidelines and Protocols 2006; Computer-based Clinical Guidelines and Protocols 2008) and a related community who held a series of three workshops / special tracks devoted to the formalization, organization, and deployment of procedural knowledge in healthcare (CBMS’07 Special Track on Machine Learning and Management of Health Care Procedural Knowledge 2007; From Medical Knowledge to Global Health Care 2007; Knowledge Management for Health Care Procedures 2008). Since then, two more KR4HC workshops have been held, in conjunction with the ECAI’10 and the AIME’11 conferences.

The first ProHealth workshop took place in the context of the 5th Int’l Conference on Business Process Management (BPM) in 2007. The next three ProHealth Workshops were also held in conjunction with BPM conferences (BPM'08, BPM’09, and BPM’11). The aim of ProHealth has been to bring together researchers from the BPM and the Medical Informatics communities. As the workshop was associated with the BPM conference that had never been attended by researchers from the Medical Informatics community, we had included Medical Informatics researchers as keynote speakers of the workshop, members of the program committee, and to our delight, saw a number of researchers from the Medical Informatics community actively participating in ProHealth workshops. Following the keynote talk given by Manfred Reichert from the BPM community at the Artificial Intelligence in Medicine 2011 (AIME’11) conference, where KR4HC was held, the organizers of ProHealth and KR4HC workshops have shown their interest to hold their workshops in conjunction as part of the BPM'12 conference, which marks a landmark in the collaboration between the two communities. We are continuing the efforts that started four years ago by members of the Software Engineering in Health Care (SEHC) community to strengthen the collaboration between the ProHealth and SEHC communities.

Workshop Theme

Original contributions are sought, regarding the development of theory, techniques, and use cases of Artificial Intelligence and / or process management in the area of healthcare, particularly connected to patient data, clinical guidelines and healthcare processes.

Submitted papers will be evaluated on the basis of significance, originality, technical quality, and exposition. Papers should clearly establish their research contribution and the relation to the goals of the workshop. The scope of the workshop includes, but is not limited to the following areas:

• Process modeling in healthcare
• Computer-interpretable clinical guidelines / protocols and decision support
• Workflow management in healthcare
• Semantic integration of healthcare processes with electronic medical records
• Knowledge representation and ontologies for healthcare processes
• Temporal knowledge representations and exploitation
• Facilitating knowledge-acquisition of healthcare processes
• Visualization, monitoring and mining healthcare processes
• Knowledge extraction from healthcare databases and EPRs
• Knowledge combination, personalization and adaptation of healthcare processes
• Compliance of healthcare processes
• Evaluation of quality and safety of careflow systems
• Managing flexibility and exceptions in healthcare processes
• Process optimization and simulation in healthcare organizations and healthcare networks
• Experiences in deploying knowledge-based tools in healthcare
• Patient empowerment in healthcare
• Linking clinical care and clinical research
• Lifecycle management for healthcare processes
• Context-aware healthcare processes
• Ambient intelligence & smart processes in healthcare
• Mobile process support in healthcare
• Process interoperability & standards in healthcare
• Process-oriented system architectures in healthcare

Format of the Workshop

The 1-day workshop will comprise accepted long and short papers, tool presentations, and 1 keynote. Papers should be submitted in advance and will be reviewed by at least three members of the program committee. An informal proceedings will be available during the workshop. At least one author for each accepted paper should register for the workshop and present the paper. The selected best long (full) papers will be included in the formal proceedings, which are expected to be published as part of the LNAI Springer series, as it was done in all previous editions of the workshop.

Paper Submission

Prospective authors are invited to submit papers for presentation in any of the areas listed above. Only papers in English will be accepted. Three types of submissions are possible: (1) full papers (12 pages long) reporting mature research results, (2) position papers reporting research that may be in preliminary stage not yet been evaluated, and (3) tool reports. Position papers and tool reports should be no longer than 6 pages. Papers must present original research contributions not concurrently submitted elsewhere.
Papers should be submitted in the LNCS format. The title page must contain a short abstract, a classification of the topics covered, preferably using the list of topics above, and an indication of the submission category (regular paper, position paper, or tool report). Papers (in PDF format) should be submitted electronically via the Easychair system

https://www.easychair.org/conferences/?conf=kr4hcprohealth2013.