Royal Colleges 3.0: ‘Best Practice As Code’

Royal Colleges 1.0

(I think they also used to call them just, er, ‘Royal Colleges’)

Royal Colleges 2.0

In the late 1990s and especially in the 2000s–10s, Royal Colleges started, at varying speeds and with varying alacrity, to adopt the publishing models of the Internet age. We now, fairly reasonably, expect a Royal College’s latest guidance to be published in some digital format.

Royal Colleges 3.0

Following on from the scene-setting above, what we need is a way to bring best practice right into the electronic patient record, dynamically, and on-demand. And there have already been attempts to do this, in the form of simple clinical calculators and decision support templates. For the purposes of this blog I’ll group all of them under the term digital clinical tools.


Digital clinical helpers and tools have existed for many years, but these have been very sporadically deployed in specific patient records systems. Where one system implements a clinical tool, other systems may not do so. Without ubiquity they will not become established in clinical practice.

Clinical accuracy and safety

We need these digital clinical tools to be safe and accurate for clinical use. Which organisations have the capability, will, and trusted stature to build and distribute these tools? Who better than the Royal Colleges, who have always been in the business of providing clinical guidance and knowledge, to own these clinical artefacts? Sure they’ll need to upskill in order to do so — but 25 years ago none of the Royal Colleges had a website, they had to upskill to move to RC2.0 — they’ll do the same for RC3.0.

How to do this RIGHT

Do the hard work to make the API simple: Publish robust REST APIs with a good developer experience, rich documentation, responsive support, user and developer forums, SLAs for uptime and build a community of those who use them, build them, and test them.

Get involved & spread the word

Clinical informaticians, clinicians and health techies like us can be part of the solution, recognising that the clinicians’ digital tool-set needs to be upgraded, encouraging respected organisations like Royal Colleges to consider this a legitimate part of their remit, building those tools, and helping the profession move forward into a world where these tools are widely available.



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Marcus Baw

Marcus Baw

#HIT100 NHS GP | Clinical Informatician | Ruby & Python dev | co-founder NHSbuntu & openGPSoC | Freelance Health IT