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Showing results for tags 'Electronic Health Record'.
Found 124 results
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Content ArticleThe importance of big health data is recognised worldwide. Most UK National Health Service (NHS) care interactions are recorded in electronic health records, resulting in an unmatched potential for population-level datasets. However, policy reviews have highlighted challenges from a complex data-sharing landscape relating to transparency, privacy, and analysis capabilities. In response, authors of this study, published in The Lancet Digital Health, used public information sources to map all electronic patient data flows across England, from providers to more than 460 subsequent academic, commercial, and public data consumers. Although NHS data support a global research ecosystem, they found that multistage data flow chains limit transparency and risk public trust, most data interactions do not fulfil recommended best practices for safe data access, and existing infrastructure produces aggregation of duplicate data assets, thus limiting diversity of data and added value to end users. They provide recommendations to support data infrastructure transformation and have produced a website to promote transparency and showcase NHS data assets.
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News ArticleA trust saw nearly 1,000 safety reports filed after introducing a new electronic patient record (EPR) – including one where a patient died and 30 others where they suffered harm. The Royal Surrey Foundation Trust and Ashford and St Peter’s Hospital Foundation Trust installed a new joint EPR system in the middle of last year. But Royal Surrey’s board was told there had been 927 Datix reports — which are used to raise safety concerns — related to the introduction of the “Surrey Safe Care” system, running up until mid September this year. The catastrophic harm involved a patient death which the trust says was not “directly linked to technical problems” with the EPR, as “human factors” were involved, including inexperience or unfamiliarity with the electronic prescribing system. Louise Stead, chief executive of Royal Surrey, said: “Implementing an electronic patient record is a huge shift for any workforce and we experienced some issues with the functionality of the system and getting users sufficiently trained and confident in using it correctly. We have worked hard to address these issues as quickly and responsibly as possible. “Our fundamental aim is for ‘zero harm’ and any harm caused to a patient is taken extremely seriously and investigated. In the case of these Datix incidents the vast majority (over 99%) resulted in low or no harm to patients. “However, one case resulted in the tragic death of a patient and we have been working closely with their family to be transparent and learn every possible lesson. This case was not directly linked to technical problems with the electronic patient record system and human factors did contribute. We are sincerely sorry for the failure in their care and devastating impact upon this person’s family.” Read full story (paywalled) Source: HSJ, 11 October 2023
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Content ArticleThis article published by the Betsy Lehman Center looks at the benefits of real-time monitoring of electronic health records (EHRs). Early adopter hospitals have demonstrated dramatic gains in safety by monitoring patients' EHR's in real time for signals of potential safety events, allowing providers to more quickly and effectively address safety gaps and improve outcomes. This monitoring is carried out by automated safety surveillance software that continuously runs in the background of EHR systems and can detect hundreds of categories of adverse events as they occur. Expert analysis then quickly helps organisations gain insight from the data, which can be used to proactively reduce safety risks and reliably measure incidence of harm over time.
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News Article
24,000 hospital letters lost in computer error
Patient Safety Learning posted a news article in News
A hospital trust failed to send out 24,000 letters from senior doctors to patients and their GPs after they became lost in a new computer system, the BBC has learned. Newcastle Hospitals warned the problem, dating back to 2018, is significant. The BBC has been told the problems occurred when letters requiring sign-off from a senior doctor were placed into a folder few staff knew existed. The healthcare regulator has sought urgent assurances over patient safety. Most of the letters explain what should happen when patients are discharged from hospital. But a significant number of the unsent letters are written by specialist clinics spelling out care that is needed for patients. It means that some crucial tests and results may have been missed by patients. Staff have been told to record any resulting incidents of patient harm and ensure these are addressed. Following a routine inspection by the regulator - the Care Quality Commission (CQC) - in the summer, staff at the trust raised concerns about delays in sending out correspondence. A subsequent review of the trust's consultants revealed that most had unsent letters in their electronic records. Read full story Source: BBC News, 26 September 2023 -
Content ArticleRecent polling from Healthwatch England shows that a fifth of patients referred by a GP for consultant-led care end up in a ‘referral black hole’, with more than two million patients each year having to make four or more visits to their GP before a referral is accepted. The result is that tens of thousands of patients could be on a ‘hidden’ waiting list, meaning that GPs are managing greater clinical risk and a greater number of patients whose conditions are often worsening in primary care, whilst communication between providers and access to diagnostics are often not up to scratch. This report by the think tank Policy Exchange looks at reforms that could be made to the interface between primary and secondary care in order to improve care and prevent patient harm. It considers how improved flows of information and expertise can: better support growing demand in general practice reduce unwarranted variation in service provision enhance care coordination – particularly for those referred for elective procedures enable opportunities to boost generalist medical skills for a new generation of doctors create opportunities for hospital specialists to deliver a greater proportion of care in primary or community care settings, reducing waiting times and the use of more expensive settings for care.
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News Article
‘Staggering’ paper use revealed as NHS told electronic records safer
Patient Safety Learning posted a news article in News
The NHS still relies heavily on paper notes, with experts warning they are not as safe or efficient as electronic records. It comes after a survey by the British Medical Journal (BMJ) found the majority of NHS trusts are still using paper, despite 88% of all trusts in England being equipped with electronic patient record (EPR) systems. Of 182 trusts, 4% said they only use paper notes, while 25% are fully electronic. Some 71% use both paper and an EPR system. Of the 172 trusts that responded to questions on prescriptions, 9% said they only use paper drug charts, 27% are fully electronic, and 64% use a mixture. Writing for the BMJ, freelance journalist and doctor Jo Best argued that the continued reliance on paper is less safe and efficient, while difficulties around sharing electronic records could be preventing even the most advanced trusts from realising their full potential. Read full story Source: The Independent, 14 September 2023 -
Content ArticlePatients and families are key partners in diagnosis, but there are few methods to routinely engage them in diagnostic safety. Policy mandating patient access to electronic health information presents new opportunities, and in this study, researchers tested a new online tool—OurDX—that was codesigned with patients and families. The study aimed to determine the types and frequencies of potential safety issues identified by patients with chronic health conditions and their families and whether their contributions were integrated into the visit note. The results showed that probable Diagnostic Safety Opportunities (DSOs) were identified by 7.5% of paediatric and adult patients with underlying health conditions or their families. Among patients reporting diagnostic concerns, 63% were verified as probable DSOs. The most common types of DSOs were patients or families not feeling heard, problems or delays with tests or referrals and problems or delays with explanation or next steps. In chart review, most clinician notes included all or some patient/family priorities and patient-reported histories. The researchers concluded that OurDX can help engage patients and families living with chronic health conditions in diagnosis. Participating patients and families identified DSOs and most of their OurDX contributions were included in the visit note.
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Content ArticleThe SAFER Guides are designed to help healthcare organisations conduct self-assessments to optimise the safety and safe use of electronic health records (EHRs). Each of the nine SAFER Guides begins with a Checklist of “recommended practices.” This Patient Identification SAFER Guide identifies recommended safety practices associated with the reliable identification of patients in the EHRs. Accurate patient identification ensures that the information presented by and entered into the EHR is associated with the correct person. Processes related to patient identification are complex and require careful planning and attention to avoid errors. The SAFER Guides are produced by The Office of The National Coordinator for Health Information Technology.
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Content ArticleThis toolkit provides information about how the US Department of Health and Human Services Office of the Director General conducted recent medical record reviews to identify patient harm. It outlines the decision criteria for adverse events and describes the methods used in the report, 'Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm' in October 2018, building upon a broader series of reports about adverse events in hospitals and other health care settings.
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News ArticleVanderbilt University Medical Center is facing a federal civil rights investigation after turning the medical records of transgender patients over to Tennessee’s attorney general, hospital officials have confirmed. The U.S. Department of Health and Human Services’ investigation comes just weeks after two patients sued VUMC for releasing their records to Attorney General Jonathan Skrmetti late last year. “We have been contacted by and are working with the Office of Civil Rights,” spokesperson John Howser said in a statement late Thursday. “We have no further comment since this is an ongoing investigation.” VUMC has come under fire for waiting months before telling patients in June that their medical information was shared late last year, acting only after the existence of the requests emerged as evidence in another court case. The news sparked alarm for many families living in the ruby red state where GOP lawmakers have sought to ban gender-affirming care for transgender youth and limit LGBTQ rights. The patients suing over the release of their information say VUMC should have removed personally identifying information before turning over the records because the hospital was aware of Tennessee authorities’ hostile attitude toward the rights of transgender people. Many of the patients who had their private medical information shared with Skrmetti’s office are state workers, or their adult children or spouses; others are on TennCare, the state’s Medicaid plan. Some were not even patients at VUMC’s clinic that provides transgender care. “The more we learn about the breadth of the deeply personal information that VUMC disclosed, the more horrified we are,” said attorney Tricia Herzfeld, who is representing the patients. “Our clients are encouraged that the federal government is looking into what happened here.” Read full story Source: NBC News, 10 August 2023
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News Article
Cyber attack takes out two trusts’ records access
Patient Safety Learning posted a news article in News
Two ambulance trusts have been left without a working electronic patient care record system for a week after a cyber attack affecting its Swedish-based supplier. Staff at South Western Ambulance Service Foundation Trust and South Central Ambulance Service FT have been working on paper since the MobiMed system – supplied by the firm Ortivus – went down last Tuesday. More than 1,700 ambulances and clinical workstations use the system, according to the company. One employee told HSJ some staff were struggling with a paper-based system which meant they had less information on patients. ”We can’t do summary care record searches or see previous call information,” the staff member said. SWASFT sent a message to staff on Friday saying the system was likely to be down “for a prolonged period”. Read full story (paywalled) Source: HSJ, 25 July 2023 -
News Article
Digitising all trusts by 2025 ‘unachievable’ after £700m cut, government admits
Patient Safety Learning posted a news article in News
NHS England’s target for all trusts to have a working electronic patient record (EPR) system by March 2025 is now ‘unachievable’’ and a new date has been set a year later, government has admitted. A new report of the Infrastructure and Projects Authority – the government body which scrutinises and supports major projects – states: “Delivery confidence is [rated] red as a number of NHS trusts are reporting they are unlikely to be able to fully implement an electronic patient record by March 2025.” The document, published quietly last week, downgrades the rating from “amber” to “red” – and also reveals £700m was cut from the programme’s budget last year. The “frontline digitisation” programme was launched by government and NHSE in 2021 with the aim of getting all trusts to a minimum level of capability, including 90% to have an EPR of an acceptable standard by the end of 2023, and 100 per cent by March 2025. But the IPA report states that a revised business case is now being prepared to reflect a new “end date” of March 2026. Read full story (paywalled) Source: HSJ, 24 July 2023 -
Content ArticleThe Digital Medicines Transformation Portfolio aims to use digital technologies to make prescribing, dispensing and administering medicines everywhere in Wales, easier, safer and more efficient for patients and professionals. It brings together the programmes and projects that will deliver a fully digital prescribing approach in all care settings in Wales. This video outlines the different elements of the portfolio that will be introduced across primary and secondary care, including the Shared Medicines Record, which will store information about a patient's medications all in one place.
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Content ArticlePoorly designed electronic health records (EHRs) are common, and research shows poor design consequences include clinician burnout, diagnostic error, and even patient harm. One of the major difficulties of EHR design is the visual display of information, which aims to present information in an easily digestible form for the user. High-risk industries like aviation, automotive, and nuclear have guidelines for visual displays based on human factors principles for optimised design. In this study, Pruitt et al. reviewed the visual display guidelines from three high-risk industries—automotive, aviation, nuclear—for their applicability to EHR design and safety.
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Content ArticleThis report by Healthcare Inspectorate Wales (HIW) relates to vascular services provided by Betsi Cadwaladr University Health Board following the de-escalation of these services as a Service Requiring Significant Improvement (SRSI). The review outlines that while progress has been made against all nine recommendations made by the Royal College of Surgeons, the health board still has improvements to make.
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Content ArticleIn this blog, Clare Crowley and Nick Woodier, National Investigators at the Healthcare Safety Investigation Branch (HSIB) look at the simple but often overlooked measures that NHS staff and organisations can take to improve the design and display of information in the workplace. They refer to a recent HSIB investigation that highlighted how the choice of information to display, and the visibility and accuracy of that information, can influence how NHS staff access and use it.
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News Article
Twenty-four UK doctors in five years censured over medical record breaches
Patient Safety Learning posted a news article in News
Twenty-four doctors have been disciplined by the UK medical regulator in the last five years after accessing and using information from patients’ treatment records without good reason. The General Medical Council (GMC) said it had struck off two of the 24 doctors it had sanctioned after finding that they had undertaken “inappropriate use” of medical records. Another 10 were suspended, 10 were warned about their future conduct, one had a condition imposed on their licence to practise medicine and the other had to undertake not to repeat their behaviour. The 24 cases were among 194 incidents of doctors allegedly accessing medical records without a clinical justification that prompted a complaint to the regulator between 2017 and 2022. Privacy campaigners said it was shocking that almost 200 people had made complaints to the GMC accusing doctors of violating patients’ confidentiality in that way. Read full story Source: The Guardian, 13 June 2023 -
News Article
‘Archaic’ and risky patient records still used by most GP practices
Patient Safety Learning posted a news article in News
Most GP practices in England are still using ‘archaic’ Lloyd George paper records despite a commitment to digitise them, HSJ has found. NHS England’s 2019 GP contract included a commitment to do away with the so-called “Lloyd George envelopes” – named after the early 20th century prime minister who introduced a pre-NHS health insurance scheme – and digitise them by 2022-23. The NHS stopped issuing new envelopes for first-time registrations in January 2021. But Freedom of Information requests submitted by HSJ have revealed that the famous brown paper records, some of them many decades old, are still widely used in England. Where they are still used, staff typically use electronic records for new information, but have to find and consult the paper records occasionally, when they need older information. This is less efficient than if the records had been digitised, and storing the paper records takes up several rooms in many practices. Read full story (paywalled) Source: HSJ, 5 June 2023 -
News ArticleAn integrated care board (ICB) has advised its GP practices not to give patients automatic access to their records, contradicting NHS England national requirements. Instead, North East London ICB has suggested practices only allow access where patients request it, and subject to conditions. The national go-live date for patients to be allowed automatic access to future entries in their records has been repeatedly delayed since initially being set at December 2021. GPs have argued they needed more time to redact sensitive information, ensure records are not inappropriately shared, and train staff. They have cited workload and safeguarding concerns. The ICB’s chief clinical information officer Osman Bhatti, who is a GP, told HSJ the ICB instead “wanted a process where patients could access both prospective and retrospective records safely, with less workload for GPs and so patients who actually want access can have it”. Read full story (paywalled) Source: HSJ. 1 June 2023
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News Article
GMC to investigate ‘stalker’ doctor who shared patient’s records
Patient Safety Learning posted a news article in News
The UK medical regulator has launched an investigation into a “stalker” doctor who accessed intimate details of the health history of a woman who had begun dating the doctor’s ex-boyfriend. The General Medical Council (GMC) is investigating whether the doctor – a consultant at Addenbrooke’s hospital in Cambridge – breached their professional, ethical and legal duties to protect the woman’s personal information. The victim has given the watchdog a statement detailing the consultant’s repeated violations of her medical records and documentation that shows what she did. The GMC declined to comment because it has not yet decided to open a formal disciplinary case against the consultant, who could face serious sanctions including a ban on working as a doctor. One of the GMC’s investigative officers is examining the victim’s claims and collecting evidence. The Guardian revealed how the doctor had looked at the victim’s hospital and GP records seven times last August and September, in the early stages of the woman’s relationship with a man the consultant had been involved with for several years. Read full story Source: The Guardian, 15 May 2023 -
News Article
Warnings over NHS data privacy after ‘stalker’ doctor shares woman’s records
Patient Safety Learning posted a news article in News
The confidentiality of NHS medical records has been thrown into doubt after a “stalker” hospital doctor accessed and shared highly sensitive information about a woman who had started dating her ex-boyfriend, despite not being involved in her care. The victim was left in “fear, shock and horror” when she learned that the doctor had used her hospital’s medical records system to look at the woman’s GP records and read – and share – intimate details, known only to a few people, about her and her children. “I felt violated when I learned that this woman, who I didn’t know, had managed to access on a number of occasions details of my life that I had shared with my GP and only my family and very closest friends. It was about something sensitive involving myself and my children, about a family tragedy,” the woman said. The case has prompted warnings that any doctor in England could abuse their privileged access to private medical records for personal rather than clinical reasons. Sam Smith, of the health data privacy group MedConfidential, said: “This is an utterly appalling case. It’s an individual problem that the doctor did this. But it’s a systemic problem that they could do it, and that flaws in the way the NHS’s data management systems work meant that any doctor can do something like this to any patient. Read full story Source: The Guardian, 14 May 2023 -
Content ArticleThe Diabetes Record Information Standard defines the information needed to support a person’s diabetes management. It includes information that could be recorded by health and care professionals or the person themselves that is relevant to the diabetes care of the person and should be shared between different care providers. It was commissioned by NHS England and developed in partnership with the Professional Record Standards Body (PRSB). The Diabetes Self-Management Information Standard defines the information that could be recorded by the person themselves (or their carer) at home (either using digital apps or medical technology, for example, continuous glucose monitors or insulin pumps) and shared with health and care professionals.
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Content ArticlePatients have expressed a growing interest in having easy access to their personal health information, and internationally there has been increasing policy focus on patient and care records being more accessible. Limited research from the UK has qualitatively explored this topic from the primary care staff perspective. This study, published in BMC Health Services Research, aimed to understand what primary care staff think about patients accessing electronic health records, highlighting errors in electronic health records, and providing feedback via online patient portals.
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Content ArticleThis webinar hosted by the Patients Association looked at the benefits to patients of accessing their GP health records online, and answered questions from patients about how to access this information.
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Content ArticleThe first ever HETT North event, which brought together digital health leaders from across the country, took place in March 2023 in Manchester. The event highlighted the latest advancements in digital healthcare, and this blog reports on the final keynote session of the day, which focused on ‘Assessing the landscape of digital health transformation – past, present & future’. Key topics included identifying underlying issues that need to be addressed to allow for digital transformation, and the policy surrounding digital transformation in Integrated Care Systems (ICSs). Alongside Clive Flashman, Patient Safety Learning's Chief Digital Officer, the panel included: Sam Shah, Chair, HETT Steering Committee Henrietta Mbeah-Bankas, Head of Blended Learning & Digital Learning & Development Lead, Health Education England Tremaine Richard-Noel, Head of Emerging Technology, Northampton General Hospital NHS Foundation Trust Liz Ashall-Payne, CEO, ORCHA You can watch a video of the discussion on Youtube.
