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Content Article
This guide is for trusts who have an electronic patient record system (EPR) already in place and want to realise the transformational opportunities it presents. It focuses on the role of the board in leading these changes. In December 2022, NHS England estimated that over 85% of trusts in England had some form of EPR and set a target for EPRs to be implemented in at least 90% of trusts by December 2023. A well implemented and optimised EPR improves patient safety, staff satisfaction, patient flow and data quality. But this can only be achieved with continuous optimisation and investment. A poor EPR implementation, followed by a lack of investment in its ongoing development, can frustrate staff and create disillusionment. This in turn leads to poor usage and unsafe workarounds. In time this will negatively impact productivity and result in substandard data informing clinical decision making. If you are part of an integrated care system (ICS) looking to share or align EPRs across a number of organisations, this guide will also help you consider issues of convergence, scale and shared governance. It does not address procurement and implementation.- Posted
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- Electronic Health Record
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Content Article
The NHS is the world’s largest publicly funded health service. It is also the world’s largest repository of healthcare data, but these data are fragmented and underutilised. Making them accessible in one place would improve health and deliver wealth for the nation. This report by the Tony Blair Institute for Global Change proposes the creation of a National Data Trust (NDT)—an organisation which would be majority-owned and controlled by the government and the NHS, together with investment from industry partners. It would aim to connect NHS data, attract private investment in new medical discoveries and bring the economic benefits of health innovation to citizens. The authors believe the NDT would accelerate the NHS’s development of cutting-edge innovations, provide quicker access to these advancements at reduced costs and generate a new funding source for the healthcare system.- Posted
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Event
This webinar for UK healthcare professionals will be delivered by DISN UK Group committee members. It will focus on using diabetes technology–insulin pumps, CGM, POCT–in the hospital. We will discuss and outline the newest JBDS technology guideline and provide the attendees with most up to date information regarding using diabetes technology when a person with diabetes is admitted to hospital. Educational outcomes – 3 points: Recognise different types of diabetes technology Use of diabetes technology in the different scenarios in inpatient setting Effective support for people with diabetes and use of diabetes technology when admitted to hospital Register for the webinar- Posted
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Content Article
Sofia Mettler, MD, describes the day when the electronic medical records (EMR) system at her hospital failed and the impact this had on clinical decision making. She highlights that the downtime forced doctors across the hospital to speak with patients about their condition and symptoms, and to collaborate with the nurses who had been monitoring them all night. It also made her realise that the many test results she was used to referencing for every patient were not all necessary to make clinical decisions. She reflects, "The EMR downtime made me realise that while the system seems to make our clinical routine convenient, it may not result in increased efficiency or better patient care."- Posted
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- Electronic Health Record
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Content Article
Acute inpatient mental health services report high levels of safety incidents. The application of patient safety theory has been sparse, particularly concerning interventions that proactively seek patient perspectives. This recently published NIHR report details research to explore safety on acute mental health wards from patient perspectives using real-time technology.- Posted
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- Mental health
- Hospital ward
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Content Article
The National Academies of Sciences, Engineering, and Medicine (NASEM) report Improving Diagnosis in Health Care calls for healthcare professionals to engage patients in diagnostic decision making. Patient engagement refers to the concept of patients being actively involved in their healthcare, including but not limited to engaging with medical providers and the health system in diagnosis, treatment, and overall disease management decisions. The emergency department (ED) presents unique challenges to engage patients in the diagnostic process. Patients evaluated in the ED typically have no prior relationship with the care team. Engagement is further challenged in the unpredictable, chaotic environment where clinicians operate in time-constrained situations and care for multiple patients simultaneously. Finally, patients presenting to the ED may be critically ill, emotionally distressed, intoxicated, or otherwise unable to fully participate in their own care. Health information technology (IT) is increasingly used to promote patient engagement by enhancing patient-provider communication, ensuring shared decision making, and enabling positive behavioural changes. Health IT tools such as electronic patient portals, mobile text messaging, health apps, and recent advancements in virtual environments offer new opportunities for patient engagement in the ED. This Agency for Healthcare Research and Quality (AHRQ) brief reviews the current state of health IT-based methods for engaging patients in the diagnostic process in the ED and outlines opportunities for further development.- Posted
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- Diagnosis
- Patient engagement
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Content Article
In this Forbes article, Robert Pearl MD looks at how AI will affect the legal situation when a patient is harmed in healthcare. He highlights growing confidence and an increasing body of research that points to generative AI being able to outperform medical professionals in various clinical tasks. However, he outlines many questions that still remain about the legal implications of using AI in healthcare. He also argues that liability will become increasingly complex, especially in places where AI is being used without direct individual oversight.- Posted
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News Article
NHS computer issues linked to patient harm
Mark Hughes posted a news article in News
IT system failures have been linked to the deaths of three patients and more than 100 instances of serious harm at NHS hospital trusts in England, BBC News has found. A Freedom of Information request also found 200,000 medical letters had gone unsent due to widespread problems with NHS computer systems. Nearly half of hospital trusts with electronic patient systems reported issues that could affect patients. NHS England says it has invested £900m over the past two years to help introduce new and improved systems. Some hospital trusts have spent hundreds of millions of pounds on new electronic patient record (EPR) systems, but BBC News has discovered many are experiencing major problems with how they work. Quoted in this article, Clive Flashman, Chief Digital Officer of Patient Safety Learning, said, “If you look at the sorts of serious issues that are coming out around the country where patients are being harmed, in some cases dying, as a result of these systems not working properly, I would imagine there are tens of thousands of these that are happening that probably never get discussed”. Read the full story. Source: BBC News, 30 May 2024 Read more about Patient Safety Learning's reflections on these issues and the importance of patient safety being at the heart of the development and implementation of EPRs here.- Posted
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Content Article
In January 2024, the Institute for Healthcare Improvement (IHI) Lucian Leape Institute convened an expert panel to explore the promise and potential risks for patient safety from generative artificial intelligence (genAI). This report is based on the expert panel’s review and discussion.- Posted
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News Article
ECG-based AI could reduce hospital mortality
Patient-Safety-Learning posted a news article in News
An artificial intelligence (AI) system that sends text messages to alert hospital physicians about the high risk for mortality in their patients reduces the number of deaths, according to a study published in Nature Medicine. Chin-Sheng Lin, PhD, associate professor of cardiology at the Tri-Service General Hospital of the National Defense Medical Center in Taipei, Taiwan, and his colleagues have developed an AI system that identifies patients with a high risk for mortality on the basis of a 12-lead ECG. The system is intended to identify patients who would benefit from intensified care. "It is widely acknowledged that providing intensive care to critically ill patients reduces mortality. Delays in providing intensive care for critically ill patients result in catastrophic outcomes. Most in-hospital cardiac arrests are potentially preventable; however, the early signs of deterioration might be difficult to identify," wrote the researchers. The authors emphasized that exactly how the AI warning messages lead to a decrease in overall mortality must still be clarified. But the results suggest that they help in detecting high-risk patients, triggering timely clinical care, and reducing mortality, they wrote. Read full story Source: Medscape, 21 May 2024- Posted
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Content Article
This study in Surgery aimed to investigate the accuracy of ChatGPT-4’s surgical decision-making compared with general surgery residents and attending surgeons. Five clinical scenarios were created from actual patient data based on common general surgery diagnoses. Scripts were developed to sequentially provide clinical information and ask decision-making questions. Responses to the prompts were scored based on a standardised rubric for a total of 50 points. Each clinical scenario was run through Chat GPT-4 and sent electronically to all general surgery residents and attendings at a single institution. Scores were compared using Wilcoxon rank sum tests. The results showed that, when faced with surgical patient scenarios, ChatGPT-4 performed superior to junior residents and equivalent to senior residents and attendings. The authors argue that large language models, such as ChatGPT, may have the potential to be an educational resource for junior residents to develop surgical decision-making skills.- Posted
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Content Article
Large language models (LLMs) are a form of artificial intelligence that can generate human-like text and functions as a form of an input–output machine. They bring great potential to help the healthcare industry centre care around patients’ needs by improving communication, access and engagement. However, LLMs also present significant challenges associated with privacy and bias that also must be considered. This blog looks at three major patient-care advantages of LLMs, as well as the potential risks associated with using them in healthcare.- Posted
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News Article
EPR causing errors and delays two years after go-live
Patient-Safety-Learning posted a news article in News
A trust is experiencing severe problems with its electronic patient record system two years after it was installed, HSJ research has revealed. A “preliminary review” into the Oracle Cerner electronic patient record – called Surrey Safe Care – at Ashford and St Peter’s Hospitals (ASPH) Foundation Trust in Surrey found the emergency department was still spending “significant time” using the system, an electronic bed board was not updated in real-time, and there were booking and workflow errors in clinics. The review, which was released to HSJ after a Freedom of Information Act request and carried out in recent months, found problems stemming from limited system training, configuration issues and insufficient technology available on wards and in clinics. The EPR went live in May 2022. The trust also had “insufficient analysts” to provide comprehensive management information. Also, performance, utilisation and management information were described as still being “under construction.” In a statement, ASPH said, “Annual reviews will be carried out to monitor the continual progress of this project. A new working group of clinical, operational, and digital staff will agree how we use existing resources to improve staff training, add extra functionality to the EPR, invest in appropriate technology and additional analysts.” Read full story (paywalled) Source: HSJ, 15 May 2024- Posted
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Content Article
In this blog, Miqdad Asaria, Assistant Professor at the Department of Health Policy at LSE, argues that AI could lead to a paradigm-shift in healthcare systems likes the NHS. He outlines how AI could help personalise medical treatments, enhance research and development of new drugs and help with the administrative burden currently undermining the productivity and efficiency of healthcare providers.- Posted
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Content Article
Implementing a new Electronic Patient Record (EPR) is a complex process and requires meticulous planning, coordination, involving change across every aspect of a healthcare organization. However, it also presents a unique opportunity to transform patient and staff experiences and enhance productivity by eliminating time-consuming manual processes. This webinar was hosted by Deloitte and brought together some of the UK digital health industry’s most experienced leaders with significant experience in implementing electronic patient records in their own organisations. Panellists included: Dr Cormac Breen, Chief Clinical Information Officer, Guy's and St Thomas' NHS Foundation Trust Jacqui Cooper, RN Chief Nursing Information Officer, Health Innovation Manchester Professor Adrian Harris, Chief Medical Officer, Royal Devon University Healthcare NHS Foundation Trust Dr Henry Morriss, Chief Clinical Information Officer, Manchester Royal Infirmary Consultant Emergency, and Intensive Care Medicine Frances Cousins, Digital Health Lead Partner, Deloitte UK Dr Afzal Chaudhry, Executive Chief Clinical Information Officer, Epic The speakers shared insights for success across a wide variety of topics including crafting a clinical safety case, safely transferring patient data, optimising staff training, preparing for operational readiness across and within organisations and change management for a successful Go-Live.- Posted
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- Electronic Health Record
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Content Article
In this article, Radar Healthcare provides a summary of the main sessions, messages and themes emerging from the Care Show London and the Digital Healthcare Show 2024, which both took place in April 2024. It discusses these topics: Embracing technology in care provision Mastering CQC-ready feedback processes The importance of integration between social care and the NHS Leveraging social media AI: The challenges and opportunities Avoiding digital fatigue: Fostering patient safety In this final section, the article highlights a presentation given by Patient Safety Learning's Chief Executive Helen Hughes and Chief Digital Officer Clive Flashman about the organisation's patient safety standards. They spoke about the standards and accompanying online patient safety assessment toolkit, an easy-to-use resource designed to help organisations establish clearly defined patient safety aims and goals, support their delivery and demonstrate achievement. The article also highlights the contribution of the hub to improving patient safety, saying, "Patient Safety Learning's platform is recognised for its excellence in sharing knowledge on patient safety. It provides a comprehensive suite of tools, resources, case studies, and best practices to support those striving to improve patient care."- Posted
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Event
untilThe theme for this year's The Private Healthcare Information Network (PHIN) forum underscores the pivotal role that advancements in AI, robotics, and data play in shaping the future of healthcare for the benefit of patients and everyone involved in the sector. The event is free to attend, but you need to book to guarantee your place. Register for the event- Posted
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Content Article
Surgical Site Infections (SSIs) can have subtle, early signs that are not readily identifiable. This study aimed to develop a machine learning algorithm that could identify early SSIs based on thermal images. Images were taken of surgical incisions on 193 patients who underwent a variety of surgical procedures, but only five of these patients developed SSIs, which limited testing of the models developed. However, the authors were able to generate two models to successfully segment wounds. This proof-of-concept demonstrates that computer vision has the potential to support future surgical applications.- Posted
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- Healthcare associated infection
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Content Article
Lots of helpful information about health and medical science is available on the internet, often found via search engines and social media. However, some online health information is false and misleading—this is called health misinformation. Health misinformation can be harmful and can be hard to recognise, as the information may appear to come from an official or safe source. This article by US-based doctor Kelly Johnson-Arbor provides advice on how to recognise health misinformation, where misinformation comes from and why it can be harmful. The author goes on to explain ways to look for reliable health information.- Posted
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- Communication
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Content Article
When operating on a patient, a surgeon may put swabs (pieces of gauze that come in a range of types, shapes and sizes) into the patient’s body to absorb bodily fluids such as blood. The operating theatre team count the swabs in and out, using a process known as reconciliation, to ensure all swabs are accounted for at the end of the operation. However, sometimes a swab can be unintentionally retained (left inside a patient’s body). This type of patient safety incident is known as a ‘Never Event’ – that is, an event that NHS England considers to be wholly preventable. This report is intended for healthcare organisations, policymakers, and the public to help improve patient safety in relation to retained swabs following invasive procedures.- Posted
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- Surgery - General
- User centred design
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Content Article
Currently, surgical site infection surveillance relies on labour-intensive manual chart review. Recently suggested solutions involve machine learning to identify surgical site infections directly from the medical record. Deep learning is a form of machine learning that has historically performed better than traditional methods, while being harder to interpret. This study proposed a deep learning model—an explainable long short-term memory network—for the identification of surgical site infection from the medical record. The study found that the model had greater sensitivity when compared to traditional machine learning methods.- Posted
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- Healthcare associated infection
- Surgery - General
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News Article
IT system which sparked safety alert dropped by 13 trusts
Patient Safety Learning posted a news article in News
More than a dozen trusts have changed their maternity IT system – or are in the process of doing so – following a national patient safety alert. NHS England issued the alert in December, after a fault was discovered with the Euroking maternity EPR, supplied by Magentus Software. It said information recorded in the EPR could overwrite previously recorded data, meaning the system could mislead clinicians. While no cases of patient harm have been reported, NHSE instructed trusts using the system to “consider if Euroking meets their maternity service’s needs” and “ensure their local configuration is safe” by June. A spokesperson for Euroking said: “We have identified a solution to the issues raised in the NPSA [alert], which has been shared with NHSE and with our customers. We’re now meeting each customer and are working with them individually to support the changes that need to be made based on their local configurations. We will continue working with the trusts to support them meeting the deadline outlined in the NPSA. “As the NPSA outlined, it has been issued as a precautionary measure and there is no evidence of harm being caused to patients.” Read full story (paywalled) Source: HSJ, 12 April 2024 Related reading on the hub: NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn?- Posted
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Content Article
In February 2023, the Department of Health and Social Care (DHSC) published the government’s Medical Technology Strategy. This set out how, over the next 5 to 10 years, the DHSC will ensure the health and social care system can reliably access safe, effective and innovative technologies. These technologies will enable the delivery of high-quality care, outstanding patient safety and excellent health outcomes, while making the best use of taxpayer money. One year into delivery of the medtech strategy, the DHSC present an update on their achievements towards establishing an innovation pathway, to realise our vision of right product, right price, right place.- Posted
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- Medical device / equipment
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News Article
Diabetes patients to be offered artificial-pancreas technology
Patient Safety Learning posted a news article in News
Tens of thousands of people with type 1 diabetes in England are to be offered a new technology, dubbed an artificial pancreas, to help manage the condition. The system uses a glucose sensor under the skin to automatically calculate how much insulin is delivered via a pump. Later this month, the NHS will start contacting adults and children who could benefit from the system. But NHS bosses warned it could take five years before everyone eligible had the opportunity to have one. This is because of challenges sourcing enough of the devices, plus the need to train more staff in how to use them. In trials, the technology - known as a hybrid closed loop system - improved quality of life and reduced the risk of long-term health complications. And at the end of last year, the National Institute of Health and Care Excellence (Nice) said the NHS should start using it. Prof Partha Kar, NHS national speciality advisor for diabetes, said the move was "great news for everyone with type 1 diabetes". "This futuristic technology not only improves medical care but also enhances the quality of life for those affected," he added. Read full story Source: BBC News, 2 April 2024 Related reading on the hub: How safe are closed loop artificial pancreas systems?- Posted
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