About the Book
Data as Foundation: Building Healthcare’s Invisible Infrastructure argues that the real engine of digital health isn’t shiny apps or platforms—it’s the meaning baked into data and the governance that preserves it as information moves between contexts. Drawing on NHS history and international practice, the book shows why decades of digitisation have under-delivered: we automated processes but neglected the substrate that makes information trustworthy, reusable and safe.
The book is organised into six parts. Part I (The Healthcare Data Paradox) explains why large programmes faltered: they treated systems as ends, not means, and assumed good data would “emerge” from implementation. It introduces the blind spots around semantic consistency, metadata and true data governance. Part II (Fundamentals of Data Management) lays the core disciplines—data vs information governance, multidimensional data quality, and the pivotal role of metadata. It reframes quality as “fitness for purpose,” and metadata as operational infrastructure, not afterthought.
Part III (Rethinking Healthcare Data) changes the vocabulary of improvement: most “data reuse” in health is actually repurposing that requires explicit transformation, provenance, and purpose-specific quality checks. It also treats data as a dynamic asset whose value and meaning evolve through use, relationships and enrichment. Part IV (Building the Infrastructure) moves from principles to architecture: standards ecosystems, metadata registries, and process documentation as the connective tissue for federated systems.
Looking forward, Part V (Enabling the Future of Healthcare) shows that trustworthy AI depends on these same foundations—explainable models, auditable data, and an organisation that measures data management maturity alongside digital maturity. It also addresses the cultural work: leadership, stewardship and literacy. Finally, Part VI (Case Studies & Implementation) distils lessons from other sectors and offers practical, maturity-based steps for programmes such as Shared Care Records, while mapping future horizons like ecosystem governance and algorithmic assurance.
Across all six parts, the theme is constant: treat data as a managed, governed, semantic resource. Build registries and processes that preserve context. Separate compliance (information governance) from capability (data governance). Invest in metadata the way we invest in EPRs. Do this and digital health becomes steadily safer, more intelligent, and easier to change—because the foundation is sound.