1) The document discusses the development needs of Scotland's informatics workforce known as KIND (Knowledge Information and Data) staff based on a 2018-2020 project. 2) It notes the healthcare system is experiencing exponential growth in data, the digital transformation of healthcare, and the impact of COVID-19, requiring KIND staff to adopt new skills and roles to support new models of integrated care. 3) It recommends a networked approach for KIND staff to collaborate across disciplines, integrate with multidisciplinary teams, and utilize new technologies to provide proactive, personalized services through a learning health and care system.

1. Developing the Informatics Workforce for
Scotland’s Health and Social Care
Collective Leadership of a Learning Health and Care System
CILIPS Webinar 27th October 2020
Dr Ann Wales, Programme Lead, Knowledge and Decision Support ann.wales@dhi-scotland.com

2. Learning and Development Needs of Informatics Workforce
- Knowledge Information and Data (KIND) Staff.
2018-2020 project by Digital Health and Care Innovation Centre,
Public Health Scotland (and predecessors), NHS Education for Scotland.
1. Thematic literature review
2. National survey (617 respondents)
3. Mapping of capability frameworks
4. Mapping of learning providers and networks
5. Two rounds of stakeholder interviews (50 in total)

3. Why is this important now?

4. Creator:Mark Torr

5. Rafi Raza – Exponential Growth and Energy Business Model.
We won’t experience 100 years of progress in the 21st century —more like
20,000 years of progress (at today’s rate.) Ray Kurzweil

6. Healthcare
knowledge
• STM publishing approaching 2.5
million articles a year.
Healthcare data
Volume
Velocity (40% increase per annum)
Variety

7. New models of health and social care
• Centred on the person not
the institution
• Activated citizens and
communities
• Self-management and
participative decisions.
• Integrated across sectors.
• Prevention and wellbeing

8. Digital transformation of healthcare
• Healthcare 4.0
• Largely driven by citizen-
generated data
• Personalised and precision
medicine – tailoring care to
individual data profile
including genetic data

9. Impact of COVID

10. Where are we and what is
needed now?

11. Current functions – “Hidden service”
KIND services mainly:
• describe and signpost information
• focus on management and treatment
• provide services to health customers
• use traditional research and statistics methods
• work within their own professional groups and organisations
• rely on legacy technology
• tend to be perceived as a back-office function

12. KIND workforce – fluid and evolving
• 72% data & info roles; 17% library/knowledge & research
Non- Clinical Clinical
HYBRID ROLES
INTER-DEPENDENCY

13. Scope for synergies across KIND disciplines
Five common core functions
1. Identifying user needs for evidence
2. Sourcing, collecting, selecting evidence
3. Organising, managing, QA, validating evidence
4. Analysing, interpreting and synthesising evidence
5. Transferring, sharing, presenting, communicating evidence

14. From Analogue to Digital
KIND Services

15. Collaborate & Network Support new models of care Use new technology
Proactive services:
Combine ALL types of
evidence in decision-
ready formats.
Transfer knowledge to
spread digital innovation
From treatment to
prevention &
wellbeing.
New users - citizens,
social care, third sector
From customer-
provider to co-
production
New generation
technologies
Real-world data
Automate routine KIND
activities.
Human-centred approach
to digital delivery

16. Technology Evidence
Translation Meta-skills
Business-Critical Skills
• Telehealthcare
• Smartphone apps
• Sensors, wearables for
remote monitoring
• Synchronous and
asynchronous consulting
• Virtual reality
• R, R-SHINY
• Cloud
• Robotics
• Genomics
Evidence from experience
Evidence beyond health
Real-time data
Advanced analytics
Artificial Intelligence –
predictive models
NLP
Literature-Based Discovery
Modelling
Scenario planning
Decision-ready actionable
evidence
Knowledge into Action for
Improvement & Spread
• User-centred design
• Co-production
• Agile delivery
• Knowledge transfer
• Human factors
• Training others in data &
health literacy
• Evaluating impact
Adaptive skills
Leadership
Emotional intelligence
Communication
Collaboration
Learning & re-learning
Problem-solving

17. Networked approach

19. Collaborative networks solution

20. Key message:
We need to
learn and
work in
collaborative
networks

21. From classic research to real
world evidence

22. Blurring of boundaries
Mark Rothko: Blurred Boundaries

23. Real world data
Real world
evidence
Insights
Service Data:
Diagnosis, Treatment,
Co-morbidities
Lived experience,
Patient Reported
Outcomes
Citizen-generated data:
Apps, Telehealth
monitoring
Genotype and
phenotype
Public health
surveillance
Advanced
analytics
Artificial
Intelligence
Pragmatic trials
Research
evidence
Classic
research &
statistical
methods
Controlled data:
Trials
Population studies

24. 4 Key Recommendations for a Networked Approach
1.Collaborate across KIND disciplines to learn together and spread
innovation.
2. Integrate KIND roles with multidisciplinary teams and service
transformation.
3. Collective leadership from national organisations – e.g. PHS, NES,
Local Govt Digital Office, SSSC, Datalab.
4. Open repository to share learning resources, products and tools
•

25. Technology
People
Art
Science

26. Engaging with the digital and data landscape
KIND staff
Telehealthcare
Synchronous consulting –
e.g. NearMe
Remote monitoring:
Sensors & wearables
Asynchronous
consulting – e.g.
InHealthcare
Genomics
Robotics
Virtual reality
Cloud platforms
Real-world data
Artificial intelligence
NLP
Literature Based Discovery

27. Embedding evidence in technology
Integrating evidence as decision support into frontline technology –
• Smartphone apps
• Electronic health records
• Telehealthcare systems
• Asynchnronous consulting systems – e.g. Inhealthcare, E-Consult.

28. Library and information skills
‘Knowledge engineering’:
• Designing digital knowledge solutions to meet user needs
• Organising knowledge for easy access at point of need
• Creating single point of access to guidelines, other point of care
knowledge and patient invormation.
• Librarians leading on search technology - AI-driven discovery based on
patterns and concepts in the literature.
• Literature Based Discovery – re-using and combining data in the
literature.
• Deconstructing knowledge to design decision support rules and
prompts.

29. This is the realisation of a quest for a single portal of information and finally gives us a
modern and user friendly platform which can be accessed by all health care staff….we
feel that this will prove to be a catalyst for development of further integrated care
pathways with smoother and more efficient patient journeys.
Associate Medical Director, NHS Lanarkshire
Clinical Companion

30. People
Citizens and patients
• Using digital information to
support self-management and
shared decision-making – e.g.
patient information and
patient/public-facing apps.
• Creative words for wellbeing
(reading groups/bibliotherapy)
• Collaboration with third sector
and public libraries
• Data, information and health
literacy training.

31. People
Relationships
• Co-production of evidence solutions, putting the person
at the centre.
• Integration with multi-professional teams.
Human factors and ergonomics
• Design evidence solutions and support implementation
for use in real-life environments.
Improvement and adoption
• Knowledge brokering skills in collaboration with
improvement and service transformation teams.
• Facilitating sharing of knowledge to sustain and spread
innovation

32. Example – combing people’s experience, real world
and research evidence.
Managing Multiple Medicines app
• Interviews and focus groups to capture patient
experience of taking multiple medicines and “What
matters to them”.
• Combining with research evidence in national
polypharmacy guidance to develop shared decision-
making tool that captures patient outcomes to support
medicines reviews.
• Librarians now offering implementation support to
facilitate new processes to embed the app in GP and
practice pharmacist workflow.
• Analytics will be applied to patient reported outcome
data pre and post-review to assess impact of medicines
reviews and improve future guidance.

33. LEARNING
HEALTH & CARE
SYSTEM
INTERPRET
DECISIONS
ACTIONSOUTCOMES
ASSEMBLE
Real world
evidence
Research
Evidence
Service Data
(e.g. EHR systems)
Patient
Generated Data
(e.g. remote monitoring
systems)
Research and
Guidance
Decision Support

34. 1) Pilot course in preparation:
Developing KIND roles in implementing & spreading digital
innovation
2) Planning development of KIND network
3) TURAS Learn website for KIND staff – signposting existing
resources.
4) Staffing and financial resource for KIND workforce
development in bid for workforce strand for Scotland’s Digital
Strategy for Health and Social Care.
Next steps

35. What lies ahead
‘The greatest adventure is what lies ahead.
Today and tomorrow are yet to be said.
The chance, the changes are all yours to make.
The mould of your life is in your hands to break.’
J.R.R. Tolkein
Use our core skills and values - using evidence, collaborating and
helping people with their information needs - to lead data-driven,
evidence-informed transformation of health and care.

36. Developing the Informatics Workforce for
Scotland’s Health and Social Care
Collective Leadership of a Learning Health and Care System
CILIPS Webinar 27th October 2020
Dr Ann Wales, Programme Lead, Knowledge and Decision Support ann.wales@dhi-scotland.com