Managing information Implementation plan 2015–2025

College of Occupational Therapists

About the publisher

www.COT.org.uk

The College of Occupational Therapists is a wholly owned

subsidiary of the British Association of Occupational Therapists

(BAOT) and operates as a registered charity. It represents the

profession nationally and internationally, and contributes widely

to policy consultations throughout the UK. The College sets the

professional and educational standards for occupational therapy,

providing leadership, guidance and information relating to research

and development, education, practice

and lifelong learning. In addition,

11 accredited specialist sections support

expert clinical practice.

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First published in 2015by the College of Occupational Therapists Ltd106–114 Borough High StreetLondon SE1 1LBwww.cot.org.uk

Copyright © College of Occupational Therapists, 2015

Author: College of Occupational TherapistsWriter: Chris AustinCategory: Guidance

All rights reserved, including translation. No part of this publication may be reproduced, stored in a retrieval system or transmitted, by any form or any means, electronic, mechanical, photocopying, recording, scanning or otherwise without the prior permission in writing of the College of Occupational Therapists, unless otherwise agreed or indicated. Copying is not permitted except for personal and internal use, to the extent permitted by national copyright law, or under the terms of a licence issued by the relevant national reproduction rights organisation (such as the Copyright Licensing Agency in the UK). Requests for permission for other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale, should be addressed to the Publications Manager at the above address.

Other enquiries about this document should be addressed to the Research and Development team at the above address.

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Whilst every effort is made to ensure accuracy, the College of Occupational Therapists shall not be liable for any loss or damage either directly or indirectly resulting from the use of this publication.

ISBN 978-1-905944-52-1

Typeset by Servis Filmsetting Ltd, Stockport, CheshireDigitally printed on demand in Great Britain by The Lavenham Press, Suffolk

Managing information Implementation plan 2015–2025

College of Occupational Therapists

iiiCollege of Occupational Therapists

Contents

1 Introduction 1

2 Informatics: an integral part of professional practice 2

3 Pre-registration education 4

4 Ensuring a skilled workforce 4

5 Occupational therapy terminology 5

6 Information standards for care records 6

7 Occupational therapy information requirements 7

8 Understanding information technologies 8

9 Digital literacy 9

10 Evidence base for occupational therapy informatics 10

11 COT annual plans 10

12 Accessing education and training 11

13 Useful resources 12

14 Informatics in COT publications 14

References 15

Further reading 16

1College of Occupational Therapists

1 Introduction

Managing Information (COT 2014a) provides a 10-year strategic vision for occupational therapy informatics. This implementation plan sets out actions and responsibilities for practitioners, educators, managers, researchers, and the College of Occupational Therapists (COT), that are required to ensure the strategic vision can be achieved.

Managing Information was launched at the COT annual conference held in Brighton in June 2014. In July 2014 COT produced a draft document setting out how the implementation plan for Managing Information would be developed. The development process was publicised in the July 2014 editions of OTNews and College of Occupational therapists Information Management newsletter, and members were invited to contribute their ideas to make the plan relevant and realistic.

The first draft implementation plan was discussed in detail at the Research and Development Board meeting held in London on 13 November 2014. A revised plan was circulated for comment to the Learning and Development Board, the English Board, Northern Ireland Board, Scottish Board and Welsh Board. Comments received led to further changes, and a third draft version, which was discussed at the Learning and Development Board meeting held in London on 10 February 2015.

A final draft version was discussed at a national expert meeting held at COT headquarters on Tuesday 3 March 2015. The meeting provided an opportunity for members from across the UK to fine tune the detail of who needs to do what, and to ensure the implementation plan was relevant and realistic. Changes agreed at the meeting were included and the amended document was submitted for publication by COT.

2 Managing Information: Implementation plan 2015–2025

2 Informatics: an integral part of professional practice

Occupational therapists can expect to see many changes in professional practice throughout their careers, particularly with respect to the use of information technologies and information management. They will need to acquire new skills and knowledge relating to informatics to keep up to date and fit to practise.

The Health and Care Professions Council (HCPC) regulate health and care professionals working in the UK, including occupational therapists. In relation to continuing professional development they say that:

Continuing professional development (CPD) is a range of learning activities through which professionals maintain and develop throughout their career to ensure that they continue to be able to practise safely, effectively, and legally, within their changing scope of practice.

(Health and Care Professions Council n.d.)

A cornerstone of this implementation plan is the recognition that informatics is an integral part of professional practice. The ongoing challenge for individuals trying to keep up to date is potentially onerous given the rapid pace and radical nature of developments in information and communication technologies and information management.

Various organisations are responsible for ensuring that there are relevant and accessible learning opportunities to help occupational therapists to keep their informatics skills and knowledge up to date. Some key organisations are listed under ‘useful resources’ in this document.

Individual occupational therapists have a clear responsibility to manage their own learning throughout their careers as set out in the College of Occupational Therapists’ (COT) Code of continuing professional development, which says that:

You are personally responsible for ensuring that you continue to learn, develop and enhance your professional skills and practice abilities as an occupational therapy professional and embed them in your practice.

(College of Occupational Therapists [COT] 2010a)

COT has a responsibility as a professional body to produce guidance and resources to support members with their informatics learning needs.

Recommendation 1COT will need to ensure that informatics is embedded, where appropriate, within its core publications and member resources.

3College of Occupational Therapists

Informatics: an integral part of professional practice

2.1 Influencing policyCOT aims to influence the development of national policies of the four countries of the UK to ensure that their strategies and implementation plans will improve access to information technologies compatible with occupational therapy practice and record keeping, and lead to better outcomes for service users.

Recommendation 2COT will need to provide guidance on occupational therapy information needs to inform national policy and the associated implementation plans of the governments of the four countries of the UK, and national bodies, such as HCPC, National Institute for Health and Care Excellence (NICE), Health and Social Care Information Centre (HSCIC), Northern Ireland Public Health Agency, NHS National Services Scotland, and NHS Wales Informatics Service.

4 Managing Information: Implementation plan 2015–2025

3 Pre-registration education

The higher education sector provides pre-registration programmes in occupational therapy that individuals must complete before they can become registered occupational therapists (Quality Assurance Agency for Higher Education 2001).

Higher education institutions (HEIs) need to ensure that students understand the principles of informatics. Through liaising with practice placement educators, the HEIs can ensure that each placement provides relevant learning opportunities. These opportunities contribute towards preparing students for engagement with digital care record systems and other information and communication technologies.

The health and care sector has a large number of digital care record systems that are proprietary and not yet designed to support all national information standards for the structure and content of care records. Despite their limitations and differences, the diverse digital care record systems do provide an opportunity for students to acquire transferrable skills in using and recording service user information, and recording their professional reasoning in care plans.

HEIs in partnership with placement providers can introduce students to a range of systems that they may encounter across their placements and ensure that information governance and information management are included in preparation for placement sessions and the wider curriculum.

4 Ensuring a skilled workforce

The professional and statutory regulatory bodies are responsible for monitoring and enforcing professional standards of practice, including consideration of practitioners’ understanding of information technologies, information management, and information governance.

Employers and commissioners have responsibility for workforce planning to ensure an adequate supply of staff. This will include occupational therapists, who will need the right skills, knowledge and values to be effective across an increasingly diverse range of sectors where occupational therapists work. As above, this will include an understanding of information technologies, information management, and information governance. For example, the ‘information and knowledge’ section in the NHS knowledge and skills framework (Department of Health 2004).

5College of Occupational Therapists

5 Occupational therapy terminology

COT has completed development of five sets of terms commonly used by occupational therapists to record service user information, namely:

• Assessments used by occupational therapists.

• Occupational therapy functional observables – problems in occupational performance and participation.

• Goals of occupational therapy intervention.

• Interventions recorded by occupational therapists.

• Outcomes following occupational therapy intervention.

The sets of terms commonly recorded by occupational therapists will be incorporated into SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) as subsets, and used by IT system suppliers to develop tools to support accurate and consistent recording of coded key service user information by occupational therapy staff.

Recommendation 3COT will continue to review the SNOMED CT subsets, with input from members, to ensure that they continue to support occupational therapy practice and record keeping.

Recommendation 4COT will continue to publish resources for members on how to use SNOMED CT subsets in care records.

Recommendation 5Occupational therapy practitioners will need to familiarise themselves with the development of SNOMED CT subsets and their use in local digital care record systems.

Recommendation 6HEIs will need to ensure that pre-registration curricula consider the policy context for recording key service user coded data and their use for secondary purposes, such as service commissioning, public health, service evaluation, data required by governments, national clinical audits, and multi-site research.

6 Managing Information: Implementation plan 2015–2025

6 Information standards for care records

Practitioners should be aware of three main types of information standard for digital care records:

• Record headings (e.g. ‘reason for referral’).

• Terminology (e.g. SNOMED CT).

• Datasets (these mandate which data items must be completed for each service user, the coded terms that can be used, and the aggregated data submitted for central processing).

The national information standards for care records have been informed by the occupational therapy record headings (COT 2011b).

Recommendation 7COT will continue to contribute to the development of relevant national information standards for care records to ensure that they are compatible with occupational therapy values, and support occupational therapy practice and record keeping, and reflect national variations. For example, bilingual care records in Wales, and record headings used in standardised assessment tools that are essential to occupational therapy practice.

Recommendation 8Occupational therapy managers will need to be aware of, and proactive in the implementation of, developments in information standards that will impact on the design and implementation of digital care records in their local care settings.

7College of Occupational Therapists

7 Occupational therapy information requirements

Information is central to occupational therapy practice and record keeping. The occupational therapy information requirements specify what is required in practice, such as: real-time access to care records, clinical decision support tools, coded occupational therapy terminology, appropriate care planning structures, and nationally agreed record headings for integrated digital care records (IDCRs).

A UK-wide survey (National Allied Health Professionals Informatics Strategy Taskforce 2014) identified that nearly half of occupational therapists do not have access to digital care records, and nearly one third have no regular access to computers at work. Access to information and communication technologies is an essential part of practitioners’ information requirements. Relevant information technologies may include the following:

• Computers with office and other relevant software.

• Digital care records.

• Digital communication devices.

• Digital templates for recording assessments.

• Digital decision support tools.

• Telecare and digital assistive technologies.

• Mobile technologies to support safe and effective working in the community.

• Analytic services to support audit, evaluation, and research activities.

The occupational therapy information requirements will inform the development of national information standards and national guidance on the design of integrated digital care record systems and associated information technologies used in health and care services in the four countries of the UK.

Recommendation 9COT will need to identify the information requirements of occupational therapists working in the UK.

Recommendation 10COT will need to promote the use of the relevant information and communication technologies needed to meet occupational therapy information requirements, to national governments in the UK, relevant national bodies, IT system suppliers, and employers. The information requirements will reflect the breadth of occupational therapy practice in diverse work settings across the UK.

Recommendation 11HEIs’ pre-registration curricula will need to refer to the proposed occupational therapy information requirements to support professional practice.

8 Managing Information: Implementation plan 2015–2025

8 Understanding information technologies

Developments in information management and information technologies continue to be rapid and often disruptive. Occupational therapists need to keep up to date with emerging developments to ensure that they understand the capabilities of new technologies and can utilise them to best benefit service users, either through occupational therapy interventions or referral to other services.

Recommendation 12COT will need to disseminate information about developments in information management and information and communication technologies, through newsletters, briefings, the COT website, and social media.

Recommendation 13Occupational therapists will need to keep up to date with developments in information management and information and communication technologies to ensure that they are aware of the capabilities and relevance to the care of individual service users, service management, and research.

Recommendation 14In order to meet the QAA benchmark statements requirements (QAA 2001), HEIs will need to ensure pre-registration curricula include information on current information technologies, information governance, and information management skills.

9College of Occupational Therapists

9 Digital literacy

Digital literacy includes use of information, managing digital identities and understanding the impact of new technologies on society. Educators, practitioners and researchers will need to ensure that they refresh their level of digital literacy in order to keep pace with developments in the information technologies.

Recommendation 15COT will need to contribute to the development of national standards of competence for digital literacy skills for health and social care professionals and care staff. This work will inform all reviews of professional standards for practice (COT 2011), and learning and development standards for pre-registration education (COT 2014b).

Recommendation 16COT will need to produce timely resources to support and enhance the digital literacy of members.

Recommendation 17All occupational therapists and occupational therapy staff will need to include digital literacy as an integral part of their continuing professional development.

10 Managing Information: Implementation plan 2015–2025

10 Evidence base for occupational therapy informatics

There is a need to identify evidence of the contribution of informatics to occupational therapy practice. COT’s Research and development strategic vision and action plan: 5-year review referred to the rapidly growing importance of information management and information technologies, and said that:

Embracing new technologies will be key to the provision of accessible and timely resources to support a range of research-based activities for all members.

(COT 2010b)

Recommendation 18COT will need to encourage members to participate in research activities that include the use of informatics in occupational therapy practice.

Recommendation 19Occupational therapy practitioners will need to publicise effective local care services where informatics is an important element. This could include writing case studies, news items, or journal articles that are published locally or nationally.

11 COT annual plans

Recommendation 20The 10-year implementation plan for Managing Information (COT 2014a) will inform the review of the COT annual work plan, to ensure that specific objectives are included that will progress the implementation plan.

11College of Occupational Therapists

12 Accessing education and training

Occupational therapists are employed in dynamic work environments characterised by ongoing changes to:

• Emerging good practice, including use of information technologies.

• Professional standards and regulation.

• Local and national government policies.

• Legislation.

One consequence is an ongoing increase in the educational requirements of the pre-registration curriculum, and for continuing professional development. The informatics element is expanding rapidly, and has to compete for space alongside other aspects of professional practice.

To date, the educational requirements of occupational therapists have been met in four ways:

• The pre-registration curriculum has focused on essential skills and knowledge required for professional practice.

• Post-registration courses have provided specialist skills and knowledge to support advanced practice and specialist roles.

• Individuals are required to participate in ongoing professional development activities.

• Health and care service providers are responsible for funding relevant courses, including time for staff participation, to ensure staff remain up to date in their skills and knowledge. This should include use of information technologies, local digital care record systems, and information governance.

Recommendation 21COT will need to continue to provide guidance to members to help them access the training they need to develop and progress their careers, as pre-registration students, and throughout their professional careers. Informatics is essential to professional practice and will be referred to in COT guidance on curriculum development, ongoing professional development, and post-registration education.

12 Managing Information: Implementation plan 2015–2025

13 Useful resources

13.1 DefinitionsHealth informatics: The knowledge, skills and tools that enable information to be collected, managed, used and shared to support the delivery of healthcare and to promote health and wellbeing. (e-learning for healthcare 2013)

Social care Informatics: Informatics is concerned with the collection, collation and analysis of data; sharing of data, information and knowledge; and developing and using technologies to facilitate this. The end result is better outcomes for service users.

13.2 SNOMED CT learning resourcesThere are various online learning resources to help raise awareness of SNOMED CT and to enable different levels of skill and knowledge depending on your role and need. At the time of publication the following resources were available:

COT Interactive Learning Opportunities Database (iLOD)CPD session: ‘SNOMED CT for OTs’

International Health terminology Standards Development Organisation (IHTSDO)IHTSDO is the international owner of SNOMED CT and responsible for developing and maintaining it. Their website has a number of learning resources that OTs may find useful. See: http://www.ihtsdo.org/snomed-ct

Health and Social Care Information Centre (HSCIC)HSCIC provides regular webinars for health and care staff to learn about SNOMED CT. It also provides eLearning modules, user guides, case studies and technical manuals for advanced users. See: http://systems.hscic.gov.uk/data/uktc/training

Info Standards websiteInfostandards.org provides information about health and social care information standards and how to get involved in their development. There is information about information standards and eLearning resources, including an introduction to SNOMED CT and short videos showing how two use two common browsers for viewing SNOMED CT. See: http://www.infostandards.org/category/areas-of-interest/clinical-terminologies/snomed-ct/snomed-elearning/

SNOMED CT browsersAlongside the webinars and other eLearning, it can be useful to try browsing through SNOMED CT to see how it is structured and to try finding specific terms that you use in your practice. A choice of suitable browsers can be found at: http://systems.hscic.gov.uk/data/uktc/snomed/browser

13College of Occupational Therapists

Useful resources

13.3 Informatics and information governanceInformation governance forms part of the suite on eLearning resources provided as part of the programme: ‘Embedding Informatics in Clinical Education’. See: http://www.eiceresources.org/online-learning/online-learning

At the time of publication there were seven modules, each would take between 30 minutes and 2 hours to complete. The modules are:

1. Introduction to information governance.

2. Access to information and information sharing in the NHS.

3. The importance of good clinical record keeping.

4. The language of health: clinical coding and terminology.

5. Clinical information systems.

6. eHealth: the future direction.

7. Patient safety and health IT.

13.4 Information securityAn important part of informatics is information security. This is a rapidly changing field but there are online resources that present key information to help individuals to protect their personal information, or that of their employers. At the time of publication there were no resources specifically aimed at helping care staff responsible for the safety of vulnerable service users. However, the following websites provided general information for members of the public:

Get Safe Online https://www.getsafeonline.org/

Cyber Streetwise https://www.cyberstreetwise.com/

US Cert https://www.us-cert.gov/ncas/tips

14 Managing Information: Implementation plan 2015–2025

14 Informatics in COT publications

Professional standards for occupational therapy practice

5.2.3 You can use information technology to the level that is required for your practice.

(COT 2011a)

College of Occupational Therapists’ learning and development standards for pre-registration education

Standard 2: Programme curriculum standards

Standard: The programme curriculum is designed to develop occupational therapists who meet the entry-level profile and regulatory standards and are fit for contemporary and developing professional practice.

Criteria: There is evidence that the curriculum reflects current professional practice climates and is agile in response to changes. (Bullet point 5)

(COT 2014b, p11)

Standard: The curriculum is designed to facilitate the development of a scholarly practitioner.

Criteria: The curriculum demonstrates how students develop to be skilled consumers of research, able to apply new understandings to the benefit of service users, the service and the profession.

The curriculum demonstrates how research skills are taught and developed throughout the programme to equip students with the knowledge required to participate in research activities.

(COT 2014b, p13)

15College of Occupational Therapists

References

College of Occupational Therapists (2014a) Managing information: A 10-year strategic vision for occupational therapy informatics. London: COT.

College of Occupational Therapists (2014b) College of Occupational Therapists’ learning and development standards for pre-registration education. London: COT.

College of Occupational Therapists (2011a) Professional standards for occupational therapy practice. London: COT. Available at: http://www.cot.co.uk/standards-ethics/professional-standards-occupational-therapy-practice Accessed on 17.03.15

College of Occupational Therapists (2011b) Standards for the structure and content of health records: supporting occupational therapy practice and record keeping. London: COT.

College of Occupational Therapists (2010a) Code of continuing professional development. London: COT.

College of Occupational Therapists (2010b) Research and development strategic vision and action plan: 5-year review. London: COT.

Department of Health (2004) NHS knowledge and skills framework (NHS KSF) and the development review process. London: DH.

E-learning for Healthcare (2013) Informed – an online introduction to the use of informatics in healthcare: health informatics. London: Health Education England. Available at: http://www.e-lfh.org.uk/programmes/health-informatics/ Accessed on 21.04.15

Health and Care Professions Council (n.d.) Standards of continuing professional development. London: HCPC. Available at: http://www.hcpc-uk.org/aboutregistration/standards/cpd/ Accessed on 12.05.15

National Allied Health Professionals Informatics Strategy Taskforce (2014) Survey of access to, and use of, informatics by allied health professionals working in the UK: preliminary results. COTIM, 177, 2–5. Available at: https://www.cot.co.uk/ehealth-information-management/cotim-newsletter Accessed on 27.04.15

Quality Assurance Agency for Higher Education (2001) Occupational therapy benchmark statement healthcare programmes: phase 1: occupational therapy. Gloucester: QAA.

16 Managing Information: Implementation plan 2015–2025

Further reading

College of Occupational Therapists (2015) Professional language to support occupational therapy practice and record keeping: interventions recorded by occupational therapists. London: COT.

College of Occupational Therapists (2014) Professional language to support occupational therapy practice and record keeping: goals of occupational therapy intervention. London: COT.

College of Occupational Therapists (2013) COT standard for SNOMED CT subset: occupational therapy functional observables – problems in occupational performance and participation. London: COT.

College of Occupational Therapists (2013) COT standard for SNOMED CT subset: Outcomes following occupational therapy intervention. London: COT.

College of Occupational Therapists (2009) SNOMED subsets to support occupational therapy: assessments used by occupational therapists. London: COT.

Health Education England (2015) Health Education England strategic framework 2014–2029. London: Health Education England.

Health and Care Professions Council (2013) Standards of proficiency for occupational therapists. London: HCPC.

Great Britain. Parliament. House of Lords Select Committee on Digital Skills (2015) Make or Break: the UK’s digital future. London: The Stationery Office.

Managing information Implementation plan 2015–2025

In 2014 the College of Occupational Therapists published Managing information, the first strategic vision for occupational therapy informatics in the UK, which explores how we can use informatics and better use of information to optimise outcomes for service users through enhanced practice, education and research.

This implementation plan translates the strategic vision into a series of 21 recommendations. While many require action by the College of Occupational Therapists, there are also important recommendations for practitioners, managers, educators and researchers whose contribution will be essential to the realisation of the strategic vision over the next 10 years. There are also several national bodies that have responsibilities related to the informatics agenda in health and social care: including developing information standards; promoting effective use of new information technologies; and regulating higher education to ensure a skilled workforce.

This implementation plan was developed with input from BAOT members, and should be read alongside Managing Information: a 10-year strategic vision for occupational therapy informatics (COT 2014).

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