Errors caused by things such as virus infections or data breaches could be reduced by more professional standards of conduct. Photograph: Roger Tooth for the Guardian
Would you trust an unqualified surgeon to replace your hip; an uncertified electrician to re-wire your house or unregistered plumber to install gas central heating? Then why do we persist with unregistered staff managing clinically critical health systems and crucial and confidential medical information?
The same goes for health informatics. We need people with specific qualifications subject knowledge, skills and tools to collect information, manage and share it to support the delivery of healthcare.
In an age where medical research and delivery of health services depend increasingly on reliable computer-based systems and accurate and up-to-date information, health informatics staff should be encouraged if not required to demonstrate their competence and professionalism through professional registration.
At UKChip we accredit individuals and publish an open register of health informatics professionals. We have established standards for professional conduct and the continuing professional development of our registrants.
Our vision is:
• Health informatics is recognised as a valued profession in both the public and private health care sectors throughout the UK.
• All persons in the UK who spend a substantial proportion of their role or time working in health informatics to be registered and thereby certified as professionals who meet defined standards of professional conduct and competence.
UKCchip has been supported and encouraged by branches of the Department of Health since its inception in 2004 and was endorsed by Lord Hunt of Kings Heath when he held a health ministerial post. However, despite that support, no secretary of state, or health minister since Lord Hunt, or Department of Health chief information officer has yet been bold enough to publicly urge relevant staff to register, let alone mandate registration.
And yet errors, disasters and scandals continue to occur in many areas where more professional standards of conduct could at the very least reduce the risk of such adverse events. These events occur in such areas as:
• Confidentiality and security breaches: it was stated in April 2010 that the NHS has reported 305 data breaches to the information commissioner's office since November 2007. This month, Brighton and Sussex University Hospitals NHS Trust may become the first NHS trust to be fined for breaching the Data Protection Act, after a contractor that it paid to destroy hundreds of hard drives instead sold them on eBay.
• Data handling errors: a major investigation was held into how a data handling blunder by the NHS led to 800,000 people having their organ donation wishes incorrectly recorded.
• Data entry and coding errors: mistakes associated with computer entry were the fourth leading cause of medication error in 2003, compared with the seventh leading cause in 2000.
• Inter-agency information exchange: numerous concerns were expressed in the Laming Report into the death of Victoria Climbié about inter-agency information exchange and exchange of information between hospitals in close proximity.
• Virus and worm infection: the November 2008 Mytob worm attack on the network of Barts and the London NHS Trust led to its 'major internal incident' plan being activated, with some ambulances redirected from A&E.
• Mismanaged system implementation and upgrades: in the US, patients at Veteran's Administration health centres were given incorrect doses of drugs and had treatments delayed due to faulty displays of their electronic health records.
What are the benefits?
The above events are just a tiny sample of what is known – many other informatics related untoward incidents never reach the glare of publicity. Registration and regulation does not automatically mean that all of the above would have been avoided, but it certainly reduces the risk of mistakes happening again..
The standards we use to assess applicants for registration cover not only their competence in informatics, but also their professional behaviour, their understanding of medicine and care, as well as the management of health services. A health informatics professional should possess a certain level of competence in all these areas.
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