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Psychiatrists and the information age: how we should learn to stop worrying and love the computer

  • Frank Holloway (a1)
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Abstract
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Cannon, D. S. & Allen, S. N. (2000) A comparison of the effects of computer and manual reminders on compliance with a mental health clinical practice guideline. Journal of the American Medical Informatics Association, 7, 196203.
Humber, M. (2004) National programme for information technology is sorely needed and must succeed – but is off to a shaky start. BMJ, 328, 11451146.
Jadad, A. R. & Delamothe, T. (2004) What next for electronic communication and health care? BMJ, 328, 11431144.
Katona, C. (2002) Informatics in mental health care. Advances in Psychiatric Treatment, 8, 163164.
Lewis, A. (2002) Health informatics: information and communication. Advances in Psychiatric Treatment, 8, 165171.
Mcclelland, R. & Thomas, V. (2002) Confidentiality and security of clinical information in mental health practice. Advances in Psychiatric Treatment, 8, 291296.
Mclaren, P. (2003) Telemedicine and telecare: what can it offer mental health services? Advances in Psychiatric Treatment, 9, 5461.
National Programme for Information Technology (2005) NHS Connecting for Health Brochure. http://www.connectingforhealth.nhs.uk/
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Psychiatrists and the information age: how we should learn to stop worrying and love the computer

  • Frank Holloway (a1)
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eLetters

Junior Doctors' Strange Love of I.T.

Anne Thompson, Consultant in Child & Adolescent Psychiatry
13 September 2005

Holloway (2005) suggests that the education of the current generationof psychiatric trainees has emphasised I.T. skills, whereas psychiatrists of an older generation may be reluctant to embrace I.T. A survey of 75 mental health doctors of various grades in Lincolnshire Partnership NHS Trust with a response rate of 64% (n=48, male/female: 38/10, mean age: 41;SD: 10), confirmed that the overall level of I.T. knowledge was better among SHOs and SpRs (n: 18; 37.5%) than Consultants and Staff grade doctors (n: 30; 62.5%).

For example, 94% of SHOs and SpRs rated their knowledge of using Power Point as good to excellent in comparison to 43% of consultants and staff grade doctors (P<_0.001. significant="significant" statistical="statistical" differences="differences" were="were" found="found" between="between" two="two" groups="groups" in="in" using="using" excel="excel" _61.1="_61.1" v.="v." _28.7="_28.7" p="p" and="and" searching="searching" medical="medical" data="data" bases="bases" _88.9="_88.9" _60="_60" one="one" hundred="hundred" percent="percent" of="of" shos="shos" sprs="sprs" stated="stated" that="that" they="they" have="have" been="been" the="the" nternet="nternet" nearly="nearly" every="every" day="day" compared="compared" to="to" _73="_73" consultants="consultants" staff="staff" grade="grade" doctors.="doctors." however="however" there="there" no="no" statistically="statistically" word="word" _94="_94" _76="_76" outlook="outlook" express="express" _72="_72" _67.="_67." reason="reason" might="might" be="be" fact="fact" these="these" are="are" most="most" commonly="commonly" used="used" programmes="programmes" on="on" trust="trust" system="system" therefore="therefore" doctors="doctors" presumably="presumably" learned="learned" use="use" out="out" necessity.="necessity." spss="spss" was="was" limited="limited" both="both" _33="_33" _20.="_20."/> Consultants and Staff Grades did, however use the Trust’s electronic patient information system more frequently than junior doctors (43% v.17%, P<_0.05. perhaps="perhaps" the="the" eventual="eventual" introduction="introduction" of="of" electronic="electronic" care="care" records="records" will="will" lead="lead" any="any" remaining="remaining" reluctant="reluctant" psychiatrists="psychiatrists" into="into" information="information" revolution.="revolution." p="p"/> Reference

HOLLOWAY F, (2005) Psychiatrists and the information age: how we should learn to stop worrying and love the computer. Psychiatric Bulletin 29, 241-243.
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Conflict of interest: None Declared

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Informatics training for psychiatrists: the European Computer Driving License

Krishma Jethwa, Senior House Officer in Forensic Psychiatry
14 July 2005

We read with great interest the article ‘Psychiatrists and the information age’ put forward by Holloway (2005). The article puts the spotlight upon informatics and highlights the need for a good Information Technology (IT) infrastructure within the NHS.

Health care organisations may well have a poor track record in IT training however we point out the unmentioned European Computer Driving License (ECDL). This is now the reference standard for basic IT skills within the NHS. The course incorporates seven modules covering basic concepts, communication and the workings of Microsoft Office. Total study time is estimated to take from thirty to seventy hours. Learning can be either self directed or under supervision. Exams are taken under supervision in a local accredited test centre. Despite training and funding being made available to nearly all NHS staff it is often only the administrative arms of the service that take up the course.

Having undertaken ECDL training in Leeds we both feel much better equipped to embrace the modern age of informatics. It is a misnomer that the ECDL is beyond those psychiatrists of an older generation since it is a perfectly accessible course designed for those with minimal IT skills. For those who promptly master the course advanced training modules are also available. For the purposes of informatics and clinical governance weencourage all psychiatrists to incorporate the ECDL as part of their personal development plan.

References:

HOLLOWAY, F. (2005) Psychiatrists and the information age: how we should learn to stop worrying and love the computer. Psychiatric Bulletin,29, 241-243.

THE EUROPEAN COMPUTER DRIVING LICENSE. http://www.ecdl.nhs.uk
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IT Skills and Psychiatry

Syed Hyder Hussain, Staff Grade Psychiatrist
06 July 2005

It is with interest that I read the article by Dr Frank Holloway on information technology skills. A few years ago, before the IT revolution, it was unthinkable what is happening today. According to Humber, 2004 The NHS is spending a staggering 6.2 billion pounds on the ITstrategy. However it is quite sad to note that still there are a few healthcare professionals who would swear by the age old, tested methods than try to keep abreast with latest developments and use the facilities on offer.So many positive outcomes have been seen with P.C. It is amazing to note what IT can do at the touch of a button. It is sad to note that even today trainees at basic specialist training do not have a dedicated P.C and other accessories. No formal training for doing literature search, which is crucial for evidence based practice exists for junior trainees.Also ECR is a good project and if every medical record is held in an electronic format, it will be an awesome achievement. Also my own experience with the PDA has been extremely good and it surprises me how I survived so long without it. I can see the difference internet has made to my colleagues back home – what was once available to select few has become available to everyone--- true democratisation indeed.Some of my colleagues in India already practice telemedicine and their opinion is that it is here to stay.Of course when the IT strategy is enormous, there is always a scope for misuse. But the need of the hour is to find out how to prevent the misuse and not limit its use.It is heartening to note that Royal College of Psychiatrists has already shown a commitment in improving the knowledge and skills of its members.I would strongly support the author’s view that improving the IT skills should be a part of personal development plan.My suggestions is to improve the IT skills at the basic specialist level as I believe in adage “catch them young” ... More

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Opportunities for improving clinical records

James D Reed, SHO in Psychiatry of Learning Disability
06 July 2005

Holloway describes the moves afoot to introduce an electronic care record(ECR). He raises concerns that 'important qualitative aspects' may be lost in the transition from existing medical records.

There is no reason to suppose that this should be the case. There is nothing contained in traditional records that cannot be easily translated to electronic form. The ‘qualitative aspects’ may be contained in freetext notes or diagrams, and any ECR adopted will inevitably contain mechanisms for including them. The technology to do so is readily available and will be needed for many other aspects of the ECR. Additionally, the fact that the record will be permanently accessible nationwide (and clearly legible) may encourage fuller and more informativerecording than at present.

Clearly, the mechanism of entry will change from pen and paper to keyboard and mouse. This will pose no problem to the many increasingly IT-literate trainees, and for some will make data entry faster and more accurate. For everyone else, emergent technologies such as voice recognition may beappropriate or else the secretarial role could be expanded to include typing of entries. Many documents (outpatient letters, minutes of meetingsetc) are already typed and held on computer, so including these in the ECRshould be straightforward.

There are clearly resource implications with regard to equipment and training, but there will also be savings as many labour-intensive aspects of paper notes(fetching and carrying, filing, locating records etc) will no longer be needed. The ECR should improve the efficiency of day-to-day work for all staff, and also improve continuity of care as it will be rapidly accessible throughout the NHS.

Many Trusts have already introduced some form of electronic patient record on a local basis with success. A change in culture is required, butthe rapid adoption of such systems in general practice shows that this is possible and can bring considerable benefits. None of the problems posed are insuperable, and with appropriate planning (and involvement of psychiatrists in the design) the ECR should surpass traditional medical records in every aspect.

Dr J D ReedSHO in Psychiatry of Learning DisabilityHeath Lane HospitalHeath LaneWest Bromwich

0121 6073071
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