Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1996
Licence: Open Government Licence
Credit: Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology. Source: Wellcome Collection.
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![Bao 16 April 1996] [Continued Chairman contd. divide these into two. One is E-mail which is the straightforward sending of text by computer and structured information which is equivalent to sending forms, if you like, electronically. Certainly we believe we could save at least £100 million a year by doing these things electronically in the NHS and that buys an awful lot of hip replacements. For forms and claims, where we can get maximum power, is when we can structure data. If you structure the information in the message you know where the information is, you can use that information for other purposes, you can use part of it in the database for research, you can use part of it for contracting, you can use part of it to automate processes like payments. Having messages structured and doing what is called true electronic data interchange, that is having things happen at both ends rather than just sending a text electronically, is where the power of computing of this sort really comes. We believe there are about one billion messages of this sort that could be sent in this structured way and we are already sending millions of them that way. In training, all training is being revolutionised by information technology and it will be so also in the NHS in due course. For example, in maintenance for skills, to have access to video banks or CD roms which tell you about procedures which you may have perhaps forgotten how to do or to more sophisticated things; where you want to learn better how to do something well. All this will maintain skills in the NHS: there will be new training methods. Lord Flowers 434. You have talked as if CD roms and videos are part of the information superhighway. (Mr Rogers) Access to video banks certainly is becoming and will become part of a superhighway. 435. It is the access bit you are talking about? (Mr Rogers) Yes. lam talking about getting access to banks of videos or banks of CD roms through a network by downloading in real time which one is already seeing in some parts of the country through British Telecom and cable companies. We know already that it is possible certainly, and one can easily see a demonstration, to be able to view an operation remotely from Surrey where I live being conducted in Newcastle real time, voice over the top, to ask the surgeon questions as it is happening. Then there is access to knowledge and to decision support systems and to care protocols through the network. Access to libraries, access to outcome databases, and we have a very good one in this country called the Cochrane Centre, and others. These are ideas that people are already bringing to us, for example to have a large databank containing images with commentaries of experts on them for the purposes of training and increasing knowledge. A networking system I think can really begin to realise evidence based medicine. We are now launching within our networking system what we call an NHS web or an intranet (which is now the word for an Internet service using worldwide web technology) which runs within an organisation as distinct from the global Internet. We are introducing such a service now in co-ordination with British Telecom. That will support also a bulletin 258649 B board facility for those who wish to communicate in this means. Also we will have access through to the global Internet but the access from our network into that global Internet will be through a secure gateway to protect people from access from without but which allows you to go from inside to outside. There will be undoubtedly new ways of getting access to care and it will have a substantial impact on the skills’ need within the NHS through telemedicine. I do not know when it will come about but certainly it will come about. There is a number of examples now in the United Kingdom where telemedicine has been practised and what is clear is that we will need in due course to think about the skill mix we have in the NHS and what we need in the future. It will have an impact on the way we distribute our care facilities. At the present time, certainly it could bring direct benefits to patient care at two ends of the spectrum, the end where you can remotely look at images, and in Queen Charlotte’s Hospital in London they run a service with the Isle of Wight for ultrasonic scans, for example. Or at a very much lower end where a GP practice at an outstation premises manned by a practice nurse can have a link which can carry images or carry a TV image. Then you have a different type of relationship now with the practice nurse than you had before. Also for the public there are new ways of getting information to the public. Interactive television is now arriving, it is arriving in the entertainment world but also it is being experimented on by British Telecom in places like Ipswich where you can get new services to people and they can interact with the computer. They call ita TV but the distinction between the TV and the computer is disappearing. You can interact with that computer in order to access information. The other day I was speaking to people in Liverpool who have an excellent CD rom about birth and they are thinking about how they can make that available to patients who attend their hospital, for example, but doing so on the network. Finally, and paradoxically I think, one of the driving forces of having an NHS wide system of networking is you can control security. What we are putting in place is a network which contains the best of security measures. I will be very pleased to describe them. They are better, they are improved and it is a vast step forward in the networks the NHS is using at present. The NHS is using hundreds of different networks at present all of them incompatible, many of them poor and many of them insecure. The networking system we are putting in place will replace those networks in due course. That is an exciting picture but I would like to go back to ground level. Our emphasis at the moment is on the basic applications of messaging, of getting access to knowledge bases through the NHS web and getting to the point of electronic communications, for example between GPs and hospitals for clinical messages, and for people doing more efficiently things like item of service claims. For that purpose I think probably about 25 per cent of dentists are already making their claims electronically to the DPB. 66 per cent at this point in time of computerised general practices are doing patient registrations electronically and most of those are now moving on to make their item of service claims electronically. In terms of the networking system](https://iiif.wellcomecollection.org/image/b32218631_0027.jp2/full/800%2C/0/default.jpg)
