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Content ArticleColoplast UK is a manufacturer of ostomy, continence, urology and wound care products. They commissioned the Patients Association to conduct a project to explore and recommend ways to better engage patients and carers in policymaking and the assessment of medical technologies for intimate healthcare. The Patients Association held a roundtable meeting and case study interviews with patients with intimate healthcare conditions and other stakeholders. They also conducted a survey of third-sector organisations who represent those patients and carried out desk-based research. This report summarises the findings of the project, which include that the existing mechanisms of engagement typically adopt a “patient involvement” approach where patients and carers do not have equal status as partners in the decision-making process. The report makes a number of recommendations to improve the way in which patients and their carers are engaged.
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News Article
Online GP access leaves patients lost, says report
Patient Safety Learning posted a news article in News
Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says. Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups. This included people with English as a second language and those less confident with technology. Online services include booking appointments, requesting repeat prescriptions and viewing test results. Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about." One Epsom and Ewell resident was asked by their surgery to book a blood test online. They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back. "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me." Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services. She said: "People feel they're being pushed online, and that spans a range of different demographics. "It's really important for practices to identify the needs of their patients and how they can best meet those." Read full story Source: BBC News, 2 February 2024 -
Content ArticleECRI's Top 10 Health Technology Hazards for 2024 list identifies the potential sources of danger ECRI believe warrant the greatest attention this year and offers practical recommendations for reducing risks. Since its creation in 2008, this list has supported hospitals, health systems, ambulatory surgery centres and manufacturers in addressing risks that can impact patients and staff.
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News Article
‘Disingenuous’ wait times on NHS App will be half those patients have to face
Patient Safety Learning posted a news article in News
Next week’s launch of the ‘Wayfinder’ waiting time information service on the NHS App will give patients “disingenuous” and “misleading” information about how long they can expect to wait for care, senior figures close to the project have warned. Briefing documents seen by HSJ show the figure displayed to patients will be a mean average of wait times taken from the Waiting List Minimum Data Set and the My Planned Care site. However, it was originally intended that the metric displayed would be the time waited by 92% of relevant patients. This is more commonly known as the “9 out of 10” measure. Mean waits are likely to be about “half the typical waiting time” measured under the 9 out of 10 metric, according to the waiting list experts consulted by HSJ. Ahead of The Wayfinder service’s launch on Tuesday, NHS trusts and integrated care boards have been sent comprehensive information on how to publicise it, including a “lines to take” briefing in case of media inquiries. This mentions the use of an “average” time but does not provider any justification for this approach. HSJ’s source said the mean average metric was “the worst one to choose” as it would be providing patients with “disingenuous” information that will leave them disappointed. They added that the 92nd percentile metric would be a “far more realistic” measure “for a greater number of people”. They concluded that “using an average” would create false expectations “because in reality nobody will be seen in the amount of time it is saying on the app.” Read full story (paywalled) Source: HSJ, 26 January 2024 -
Content ArticleOperating room black boxes are a way to capture video, audio, and other data in real time to prevent and analyse errors. This article from Campbell et al. presents the results of two studies on operating room staff's perspectives of black boxes. Quality improvement, patient safety, and objective case review were seen as the greatest potential benefits, while decreased psychological safety and loss of privacy (both staff and patient) were the most common concerns.
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Content ArticleIn November 2023, the UK hosted the first global summit on artificial intelligence (AI) safety at Bletchley Park, the country house and estate in southern England that was home to the team that deciphered the Enigma code. 150 or so representatives from national governments, industry, academia and civil society attended and the focus was on frontier AI—technologies on the cutting edge and beyond. In this Lancet article, Talha Burki looks at the implications of AI for healthcare in the UK and how it may be used in medical devices and service provision. The piece highlights the risks in terms of regulation and accountability that are inherent in the use of AI.
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Content ArticleThis study in JAMA Psychiatry aimed to assess whether multivariate machine learning approaches can identify the neural signature of major depressive disorder in individual patients. The study was conducted as a case-control neuroimaging study that included 1801 patients with depression and healthy controls. The results showed that the best machine learning algorithm only achieved a diagnostic classification accuracy of 62% across major neuroimaging modalities. The authors concluded that although multivariate neuroimaging markers increase predictive power compared with univariate analyses, no depression biomarker could be uncovered that is able to identify individual patients.
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Content ArticleHealth care algorithms are used for diagnosis, treatment, prognosis, risk stratification and allocation of resources. However, bias in the development and use of algorithms can lead to worse outcomes for racial and ethnic minoritised groups and other historically marginalised populations such as individuals with lower incomes. This study aimed to provide a conceptual framework and guiding principles for mitigating and preventing bias in health care algorithms, in order to promote health and health care equity. The authors suggested five guiding principles: Promote health and health care equity during all phases of the health care algorithm life cycle Ensure health care algorithms and their use are transparent and explainable Authentically engage patients and communities during all phases of the health care algorithm life cycle and earn trustworthiness Explicitly identify health care algorithmic fairness issues and trade-offs Establish accountability for equity and fairness in outcomes from health care algorithms.
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Content ArticleThis systematic review conducted for the Agency for Healthcare Research and Quality (AHRQ) aimed to examine the evidence on whether and how healthcare algorithms exacerbate, perpetuate or reduce racial and ethnic disparities in access to healthcare, quality of care and health outcomes. It also examined strategies that mitigate racial and ethnic bias in the development and use of algorithms. The results showed that algorithms potentially perpetuate, exacerbate and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (for example, kidney transplant allocation) or disparities in care (for example, prostate cancer screening that historically led to Black men receiving more low-yield biopsies).
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Content ArticleThis leaflet aims to help people with type 1 diabetes decide between the different technologies available to manage diabetes. It contains summaries of devices available and infographics outlining eligibility criteria for continuous glucose monitors (CGM), insulin pumps and hybrid-closed loop systems. Diabetes care is one of the five clinical areas of focus for integrated care boards and partnerships to achieve system change and improve care as part of Core20Plus5 for children and young people with the aim to increase access to real-time continuous glucose monitors and insulin pumps across the most deprived quintiles and from ethnic minority backgrounds.
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News Article
Widespread failings discovered in EPR launch linked to patient death
Patient Safety Learning posted a news article in News
“Better upfront planning, training and testing” were needed in a tech launch which was tied to patient harm and service disruption, an NHS England review has found. Royal Surrey and Ashford and St Peter’s Hospitals foundation trusts went live with Oracle Cerner’s electronic patient record in May 2022 – under a programme called Surrey Safe Care – but the implementation has since been linked to incidents of patient harm, including one death, and significant disruption to trust services. Now, a lessons learned review, carried out by NHSE’s frontline digitisation team and obtained by HSJ via a Freedom of Information request, has identified 24 areas of improvement. The key lessons cited by the review are “better upfront planning, roles and responsibilities, training and testing”. It recommended that, in future implementations, trust boards should be supported by others experienced with implementing EPRs within the NHS to “aid board level decisions and ‘what questions to ask when’”, while clearer responsibilities should also be agreed upon for programme leads and EPR suppliers. The review also found the content of training must be evaluated thoroughly, while the EPR supplier should provide “upfront and continuous training”. It added the “full end-to-end testing [by] representatives from all end user groups” should be completed before go-live. It also said EPR readiness needs to incorporate “data readiness, such as data quality, and mapping how data has originally been captured [which] may impact reporting and organisational readiness”. Read full story (paywalled) Source: HSJ, 15 January 2024 Related reading on the hub: NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn? -
Event
ISQua 2024
Patient Safety Learning posted an event in Community Calendar
untilTogether with the Türkiye Health Care Quality and Accreditation Institute (TUSKA) and the Ministry of Health, Türkiye, ISQua is delighted to host their 40th International Conference in Istanbul. The theme for the 2024 conference is 'Health for People and Planet: Building Bridges to a Sustainable Future'. It will address the continued challenges of making person-centred care part of the healthcare system, as well as addressing some of the hot topics that matter most in a rapidly changing world. Issues such as environmental challenges, reducing the healthcare sector's carbon footprint, and ensuring the long-term resilience of healthcare will be addressed at the conference. It will also examine the potentials and pitfalls of AI and Digital Transformation in healthcare, and how it can revolutionise healthcare and enable better patient engagement. Further information -
Content ArticleThe Medicines and Healthcare products Regulatory Agency (MHRA) has published a roadmap which outlines the intended timelines for delivering the future regulatory framework for medical devices.
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Content ArticleLarge language models such as OpenAI's GPT-4 have the potential to transform medicine by enabling automation of a range of tasks, including writing discharge summaries, answering patient questions, and supporting clinical treatment planning. These models are so useful that their adoption has been immediate, and efforts are already well underway to integrate them with ubiquitous clinical information systems. However, the unchecked use of the technology has the potential to cause harm. In this article for The Lancet, Janna Hastings looks at the need to mitigate racial and gender bias in language models that may be used in healthcare settings.
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Content ArticleThis cross-sectional study in JAMIA Open aimed to identify concerns, barriers and facilitators impacting the use of patient portals by older patients, as well as desired features in future updates. The authors held two focus group discussions culminating in an anonymous survey completed by women who were 65 years and older receiving urogynaecology care in Northwest Ohio. The authors concluded that the lack of age-aligned medical access software and products may lead to worsening digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who are older when designing patient portals.
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News Article
IT failures causing patient deaths, says NHS safety body
Patient Safety Learning posted a news article in News
Urgent action is needed to address NHS computer failings which are causing harm to patients, the patient safety watchdog has told BBC News. The watchdog has evidence of patient deaths due to IT system errors. The government called the reports "concerning" and said it would work with NHS England to take necessary action to protect patients. A recent investigation found thousands of hospital letters were unsent due to computer issues. The Health Services Safety Investigations Body (HSSIB) says IT failures are among the most serious issues facing hospitals in England. "We have seen evidence of patient deaths as a result of IT systems not working," said interim head, Dr Rosie Benneyworth. Dr Benneyworth cited the example of a patient who was found unresponsive and then wrongly identified by healthcare staff as not wishing to be resuscitated. Staff were unable to access information on the patient quickly through their IT system, which would have shown a mistake had been made, said the watchdog. Read full story Source: BBC News, 16 December 2023 -
News Article
Only half of trusts’ staff were trained ahead of troubled IT go-live
Patient Safety Learning posted a news article in News
Only half of staff across two acute trusts were fully trained in the use of a new electronic patient record before its introduction, which led to disruption and patient harm, HSJ has revealed. The implementation of Oracle Cerner’s EPR at Royal Surrey Foundation Trust and Ashford and St Peter’s Hospitals FT was carried out, despite the trusts not having achieved their target of 80% of staff having completed the necessary training, newly disclosed documents show. HSJ has also seen an internal report by the Royal Surrey’s informatics team which warned of risks to patient safety and data problems, unless preparations improved in the three months leading up to go-live. The two acute trusts implemented the EPR in May last year under a programme called Surrey Safe Care, but there have been multiple problems ever since – including some of the issues that the internal report warned of. The trusts acknowledged the process had been “challenging” but said they had trained a higher proportion of the staff who were working in the two weeks after go-live, with Royal Surrey describing the findings of the internal informatics report as an “inaccurate representation” of readiness. Read full story (paywalled) Source: HSJ, 13 December 2023 -
Content ArticleThe health service is facing workforce shortages and growing backlogs of care, as well as future increases in demand. In response, policymakers and providers are looking to advances in health technologies and data to improve quality and efficiency and reshape services to better meet future needs – most recently with the announcement of £100m to advance the use of artificial intelligence in health care. Ensuring new uses of health technologies or data have the backing of the public is critical if these are to become business as usual. As seen with the care.data scheme and the General Practice Data for Planning and Research programme, lack of public support can significantly constrain innovation and service transformation. So how does the UK public feel about the use of health technologies and health data? To explore this further, in March 2023 the Health Foundation commissioned a nationally representative public survey to investigate attitudes towards health technology and data uses and the key factors affecting these views.
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Content ArticleIn this blog, journalist Rory Cellan-Jones reflects on some major challenges the NHS currently faces. Sharing insights from a recent meeting with medtech companies and a lecture by economist Professor Diane Coyle, he shares concerns that productivity in the health service has decreased as a result of the pandemic, and that medtech companies face barriers in selling their solutions to the NHS. He highlights a growing consensus that policymakers need to think beyond immediate firefighting and look at how to transform the NHS over the long term.
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Content ArticleThe NHS’s deal with the US tech company Palantir raises privacy concerns, but a unified database could be a medical gamechanger writes Martha Gill in an article for the Observer. Governments have been trying to stitch together our patchwork system for decades. Billions have been lost in these attempts. However, they always run up against the same problem: people just don’t want to share their medical data, even when assured it will be anonymised. When the government aimed to build a collection of anonymous GP health records, around a million patients opted out. The latest of these attempts has closed a loophole: patients cannot now opt out. But this has enraged civil liberties groups, which are concerned about the company chosen to merge, clean and provide tools for sorting through the data.
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News Article
Patient privacy fears as US spy tech firm Palantir wins £330m NHS contract
Patient Safety Learning posted a news article in News
The NHS has sparked controversy by handing the US spy tech company Palantir a £330m contract to create a huge new data platform, leading to privacy concerns around patients’ medical details. The move immediately prompted concerns about the security and privacy of patient medical records and the suitability of Palantir to be given access to and oversight of such sensitive material. NHS England has given Palantir and four partners including Accenture a five-year contract to set up and operate the “federated data platform” (FDP). The British Medical Association, which had previously voiced concern about the NHS’s alleged lack of scrutiny of bidders on “ethical” grounds, said Palantir’s winning bid was “deeply worrying”. NHS England sought to allay such concerns. It stressed that none of the companies in the winning consortium would be able to access health and care data without its explicit consent; that it would retain control of all data within the platform; and that it would not include GP data. It said the new software would be protected by the highest possible standards of security through the deployment of “privacy enhancing technology”. Read full story Source: The Guardian, 21 November 2023 -
News Article
Private health firm Sciensus fails to fix defects that led to UK patient’s death
Patient Safety Learning posted a news article in News
A private health company paid millions by the NHS has failed to fix safety defects that led to the death of a cancer patient, the Guardian can reveal. Three patients were hospitalised and a fourth died when they were given the wrong doses of a powerful chemotherapy drug after a catastrophic IT failure at the medicine manufacturing unit of Sciensus in April this year. The incident, first revealed by the Guardian in July, prompted an investigation by the Medicines and Healthcare products Regulatory Agency (MHRA). Its inspectors found “significant deficiencies” at the Sciensus manufacturing facilities and ordered the partial suspension of its manufacturing licence. However, six months after the IT blunder, Sciensus has not fixed the problems identified by the regulator, according to people familiar with the matter. As a result, the suspension of its licence – originally due to be lifted last month – has been extended until July next year. Sciensus is the UK’s biggest provider of medicines services to NHS and private patients at home. It is contracted by the NHS and other organisations to deliver and administer medicines to more than 200,000 people with conditions such as heart disease, diabetes, dementia, HIV and cancer. Read full story Source: The Guardian, 5 November 2023 -
News Article
Hunt tech adviser calls for ‘new central investment’
Patient Safety Learning posted a news article in News
The NHS requires a ‘new central investment’ to achieve digital maturity and realise the potential of emerging technologies, according to the person who was commissioned by Jeremy Hunt to examine the issue in 2015. Bob Wachter was commissioned by the then health and social care secretary in 2015, and authored the 2016 report Making IT Work, which called on all NHS trusts to achieve the “realistic target” of a good level of digital maturity by 2023. While Professor Wachter told HSJ that there had been “reasonably good” progress, he said it was “not quite what I would have hoped for” seven years on from his report. He acknowledged that factors such as the pandemic and the subsequent economic situation slowed progress, but added that he was “a little bit worried” at the state of digital maturity in some areas, including interoperability and reliability of key systems such as electronic patient records. Read full story (paywalled) Source: HSJ, 1 November 2023 -
Content ArticleIn late 2015, the National Advisory Group on Health Information Technology in England was formed to advise the Department of Health and NHS England on its efforts to digitise the secondary care system. Our recommendations fall into two broad categories: 10 overall findings and principles, followed by 10 implementation recommendations.
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Content ArticleModern health systems must embrace digital technologies to address challenges like ongoing shortages in the global health and care workforce, significant diagnostic backlogs and the requirements of diverse and ageing populations. The COVID-19 pandemic and the exceptional advances in artificial intelligence (AI) and machine learning (ML) have accelerated the drive towards digitalisation of health systems. However, making digital health technologies work in practice remains challenging in terms of how these technologies are designed, how their performance and safety in operation are assured and how their impact on staff and on patients is assessed, writes Mark Sujan in this BMJ Editorial.
