Skip to main content

Using information technology to improve patient safety

A recent World Health Organization (WHO) Working Group that I chaired examined the potential of information technology to improve patient safety. The report from the working group was published in the journal Quality & Safety in Healthcare. Previous research has identified as significant issues the substantial variations in the quality and safety of healthcare that patients receive; and the considerable risks of iatrogenic harm to patients. These failings contribute to the high rates of potentially avoidable morbidity and mortality; and to the rising levels of healthcare expenditure seen in many health systems. There have been substantial developments in information technology in recent decades and there is now real potential to apply these technological developments to improve the provision of healthcare.

One area of international interest is the use of eHealth applications to address patient safety and quality issues. There is, however, a large gap between the theoretical and empirically demonstrated benefits of current eHealth applications. While these applications typically have the technical capability to help professionals in the delivery of healthcare, inadequate attention to the socio-technical dimensions of their use (such as user involvement in their development and in training in their use) can result in new risks to patients. Given the current lack of evidence on quality and safety improvements and on the costs & benefits associated with the introduction of eHealth applications, there should be a focus on implementing more mature technologies; it is also important that eHealth applications should be evaluated against a comprehensive and rigorous set of measures, ideally at all stages of their application life cycle.

A key step in using information technology is through introducing the use of electronic patient record systems; these systems lie at the heart of many eHealth technologies, such as electronic prescribing and computerised test ordering, as well as providing data for the identification of potential threats to patient safety. However, the introduction of electronic patient records can bring its own threats to patient safety, particularly in the early stages, when healthcare providers could be using electronic and paper-based records in parallel. One consequence of this dual usage is that the data held in electronic patient record systems can be inaccurate or incomplete, with the potential to compromise patient safety because key data items (e.g., drug allergies or important comorbidities) might not be recorded. Other key steps are to ensure the full engagement of clinicians and other professionals, and to provide adequate training to allow them to use eHealth solutions appropriately. It is also important that methods for effective data interchange between IT systems are in place if the full benefits are to be realised, and to limit the workload and errors that can arise from duplicate and unnecessary data entry.


Comments

Popular posts from this blog

Improving discharge planning in NHS hospitals

Factors that need to be considered in discharge planning that have been identified in previous projects include:

Ensuring that discharge arrangements are discussed with patients, family members and carers; and that they are given a copy of the discharge summary.Adequate coordination between the hospital, community health services, general practices, and the providers of social care services.There is a follow-up after discharge of patients at high risk of complications or readmission - either in person or by telephone - to ensure that the discharge arrangements are working well. Medicines reconciliation is carried out. This is the process of verifying patient medication lists at a point-of-care transition, such as hospital discharge, to identify which medications have been added, discontinued, or changed from pre-admission medication lists.Ensuring that any outstanding test results at discharge are obtained and passed on to primary care teams; and ensuring there are clear arrangements …

Can GPs issue private prescriptions to NHS patients?

The NHS prescription charge in England is currently £8.40 per item. At this level, many commonly prescribed drugs will cost less than the prescription charge and so some NHS patients may occasionally ask if they can have a private prescription rather than an NHS prescription.

In the past, some GPs have been advised that they could issue both an NHS FP10 and a private prescription, and let the patient decide which to use. But the British Medical Association's General Practice Committee has obtained legal advice that said under the current primary care contract, GPs in England may not issue a private prescription alongside or as an alternative to an NHS FP10 prescription. In any consultation where a GP needs to issue an FP10, the concurrent issue of a private prescription would be a breach of NHS regulations.

The issuing of a private prescription in such circumstances could also be seen as an attempt to deprive the NHS of the funds it would receive from the prescription charge. Fur…

What impact will Brexit have on the UK's life sciences sector?

On Thursday 3 November 2016, I spoke at a seminar at the Imperial College Business School on the topic of the impact of Brexit on the UK's life sciences sector (the NHS, universities, and pharmaceutical and biomedical companies). I emphasised the important role played in the life sciences sector by EU-trained professionals and the need to ensure that the UK continued to attract highly-qualified professionals to work, for example, in our National Health Service. I also discussed the need to increase spending on research and development to ensure that the UK remained a world leader in the biomedical industry. The other speakers at the seminar were Andrew Lansley (former Secretary of State for Health) and Richard Phillips (Director of Healthcare Policy at the Association of British Healthcare industries). The event was chaired by Andrew Brown. A copy of my talk can be viewed on Slideshare.