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Clinical Safety article by Dr Nick Tayler

Clinical safety systems needed to meet patient expectations for digital health

By Dr Nick Tayler, Clinical Safety Manager, InterSystems

Digital transformation in healthcare is the step-change improvement of operations and clinical care services leveraging digital technology. But thinking of it as just going paperless or inputting information into an electronic medical record grossly underestimates its potential to transform care.

When people access services online – whether news, streaming media, banking or shopping – they expect these services to recognise their digital identities and tailor their offerings according. Many people expect their health services to work similarly. Some people think they already do, but in most places, that’s not yet the case.

You could say that healthcare is behind the curve for digitisation compared to other industries. But with patient safety of the utmost importance, the adoption of digital systems is not only about taking advantage of the benefits but also weighing up and countering any associated risks.

Governance of clinical processes

In such a highly regulated industry, where clinical governance departments carefully scrutinise processes, safety in digital systems must be examined very closely. The bigger the digital footprint, the more healthcare providers are dependent on their information systems.

For example, electronic medical records (EMRs) are now widely deployed in hospitals. Their advantages include easily-accessible and legible records, a joined-up, user-friendly system, less wastage and better measurement.

However, if there’s a bug in the EMR system, it could put patients at risk. They could be prescribed a dangerous drug dose, for example, or a vital screening appointment could be missed. But, with the proper protections in place, EMRs open up a whole host of benefits for both clinicians and patients.

We are also now seeing the adoption of new digital technologies, including remote monitoring, data analytics, artificial intelligence (AI) and machine learning. Utilising the advanced interoperability capabilities of a healthcare data platform and the latest HL7® FHIR® data standard, these new technologies can be integrated with existing EMRs and other systems.

Many of our customers, for example, use InterSystems data platforms to unify their clinical and administrative data with interoperability across multiple hospitals. And many are looking to implement analytics, AI and machine learning to better leverage their clinical data and adopt innovative solutions.

Countering risks of new technologies

New digital technologies offer tremendous benefits like more accurate, faster diagnoses or personalised, more effective medical treatments. However, the expansion of digital footprints and increased dependence on such systems can leave hospitals, healthcare organisations, and ultimately patients more vulnerable to their risks and hazards.

Suppliers of these systems are responsible for designing safe, reliable, easy-to-use systems to reduce such risks. But purchasers responsible for system implementation also have an essential role in their safe configuration and in ensuring that those using the system are appropriately trained.

Supplier and purchaser activities that reduce risk and ensure the system is safe – and is used safely – come under the umbrella of a Clinical Safety Management System (CSMS), a recognised framework through which organisations can manage the risks associated with software systems.

Clinical Safety Management Systems

Building a CSMS includes formal acknowledgement of the known hazards associated with the system – known as the hazard log. An example is if a doctor prescribes a medication for the wrong patient because they were not working in the correct patient record when they started typing the prescription. In acknowledging such hazards, suppliers and purchasers can reduce their risk. In this case, a patient banner designed by the supplier to be clearly seen with the patient name and unique identifier would reduce the risk.

Similarly, increasing doctor awareness of this potential hazard in staff training can reduce its likelihood. Both suppliers and purchasers need to build a CSMS. Whilst most suppliers already have this established, many healthcare organisations are realising only now that the benefits of digitisation are associated with a risk that must be proactively managed.

Digitisation is happening across every industry, and people expect to be able to access digital health services now too. By being aware of the risks these systems pose and managing them effectively, we can leverage the benefits of digital systems in healthcare to improve the overall safety and quality of care we offer patients.

About the author

Dr Nick Tayler is Clinical Safety Manager, Asia Pacific at InterSystems, a creative data technology provider dedicated to helping customers solve their most critical scalability, interoperability and speed problems. Based in Melbourne, Australia, Tayler provides clinical expertise to assist systems architects in the development of integrated, user-focused implementations of the InterSystems TrakCare® unified electronic medical record (EMR) system across the Asia Pacific region.

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