Search the hub
Showing results for tags 'Electronic Health Record'.
Found 124 results
-
News Article
Cybersecurity strategy among dozens of tech promises missed by government
Patient Safety Learning posted a news article in News
The government has failed to meet most of its own deadlines for commitments to improve how the NHS uses data, including developing a cybersecurity strategy, HSJ can reveal. The delays include work to store and analyse patient data more securely, building public trust in the NHS’ use of patient data, and agreeing national strategies on cybersecurity and cloud technology. The strategy and its commitments were published following the Goldacre Review, which called for an overhaul of how NHS patient data is collected, stored and used. It came after the government was forced to indefinitely halt a controversial plan to collect all GP-held patient data in 2021, which resembled the fate of a similar data scheme in 2016. Several data projects have also come under scrutiny from doctors and campaigners in recent years, such as NHS England’s procurement of a new Federated Data Platform and a much-criticised trust’s data-sharing scheme with a credit rating company. Read full story (paywalled) Source: HSJ, 28 February 2023 -
Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) aims to improve patient safety by supporting staff to access critical information about patients at their bedsides in emergency situations. It defines critical information as ‘information about patients that needs to be accessed rapidly and accurately to ensure correct care is delivered when it is required’. In this investigation, critical information was considered through a focus on patient identifiers (such as name and date of birth) and decisions relating to whether someone is recommended to receive cardiopulmonary resuscitation (CPR) if their heart stops (cardiac arrest). The reference event for this investigation was the care of a patient in a hospital who was found unresponsive in bed. A short time later, he stopped breathing and his heart stopped. Help was immediately sought from the ward staff and a team gathered around the patient’s bed, where they confirmed the patient’s identity and noted that a decision had been made that he was not recommended to receive CPR if his heart stopped. As a result, CPR was not started. Around 10 minutes later, a nurse who had previously been caring for the patient returned from their break and recognised that the patient had been misidentified as the patient in the next bed. The patient whose heart had stopped was recommended to receive CPR. CPR was immediately started, but despite this, the patient died.
-
Content ArticleIn this BMJ Editorial, author Sam Patel says that linking medicines information from all care settings into a shared digital medication record accessible to all health and care clinicians has the potential to substantially reduce medication errors and improve patient safety.
-
Content ArticleThere is a huge challenge to improve technology adoption and readiness across the NHS. This article in HSJ looks at a partnership between tech services company Agyle and Dorset County Hospital (DCH) which aimed to develop a digital patient record strategy which places user experience at the heart of its approach. DCH's objective was for its staff to access a decreasing number of systems, designed around clinical processes, with data flowing seamlessly between those systems. The article looks at how Agyle and DCH worked together to achieve improved clinical safety, interoperability, cost-effectiveness and future-proofing through their strategy.
-
Content ArticleIn this interview for the Betsy Lehman Center in Massachusetts, Lee Kim Erickson, Senior Vice President and Chief Quality Officer at Wellforce, talks about maintaining a focus on patient safety during times of crisis, the impact of the Covid-19 pandemic on training for healthcare workers and the importance of maintaining a focus on care from the patient's point of view.
-
News Article
Automatic roll-out of patient access to GP records halted at eleventh hour
Patient Safety Learning posted a news article in News
In an eleventh-hour decision NHS England has halted the automatic, blanket roll-out of a scheme that would have given all NHS patients in England prospective online access to their GP-held records the day before it was due to come in. The high-profile scheme to enable patents to automatically view their GP records via the NHS app by 30 November, has been a key digital promise by successive Conservative health secretaries. The last-minute u-turn came following a series of talks between the British Medical Association (BMA) and NHS England, in which the BMA made clear many practices would not be ready to roll out the programme in a safe way for patients, and that it didn’t comply with their data protection obligations. The BMA says the decision is the ‘right thing to do’ for patient safety. The BMA said in a statement that while some practices were ready to implement this, many expressed concerns over safety aspects and that it wasn’t fit for purpose at the present time. Dr David Wrigley, deputy chair of GPC England at the BMA, said: “We’re pleased to hear that NHS England has decided to review the pace and timing of the automatic, mass roll-out of the Citizens’ Access programme. This is, without doubt, the right thing to do for patient safety. “We want patients to be able to access their GP medical records, but this must be done carefully, with the appropriate safeguards in place to protect them from any potential harm. “The deadline of 30 November was, for many practices, just too soon to do this, and removing it will come as a huge relief to GPs and their teams across the country.” Read full story Source: Digital Health, 30 November 2022 -
Content ArticleIn July 2022, HSIB launched a national investigation into the safety risk of clinical investigation booking systems failures. Specifically, the investigation explores the use of paper or hybrid booking systems and the production of appointment letters. This interim bulletin highlights a safety risk identified by the investigation and presents a safety observation for the attention of NHS care providers. Some vital NHS services still use paper-based or hybrid systems, which may have been developed over time and could leave unintended gaps where patients can be lost in the system. The reference case for this investigation is the experience of a patient whose magnetic resonance imaging (MRI) scan was not rescheduled following a cancellation, leading to a delay in the diagnosis of cancer. Hybrid systems were in use, which did not assist staff to keep track of patients. Additionally, the hybrid systems in use did not allow appointment letters in non-English languages to be produced.
-
News ArticleGP practices can block abusive patients from gaining automatic access to their records online if they pose a ‘risk of harm’ to staff, the Royal College of General Practice has said. Automatic access to patients’ prospective patient records is due to be switched on by the end of this month, following delays related to concerns about patient safety. But the RCGP’s toolkit on access to records said practices can refuse access to online records for patients that pose a risk of harm to others too. The guidance said access should "be refused where there is a clear risk of serious harm to the safety of the patient or members of the practice team, or to the privacy of a third party". It added: "If potentially harmful information cannot be successfully redacted and the practice remains concerned about the safety of record access for an individual patient – or in extreme cases, remains concerned that the patient may react violently to information in the record – then the practice may refuse to give the patient record access or restrict the level of access. "It may be possible to give them access to a reduced part of the record such as the Summary Care Record or restrict access to appointments and repeat prescriptions." The guidance said that records access should only be refused or restricted "after discussion with the practice leads for GP Online Services and Safeguarding or after seeking further professional advice from a local relevant agency or national medical indemnity organisation". Read full story Source: Pulse, 18 November 2022
-
Content ArticleFor many patients, online access to their GP’s services is a normal part of their everyday interaction with the NHS. The majority of patients in England use at least one GP Online Service to request prescriptions, book appointments or access their electronic health record. It is part of modern, responsive primary care services for patients, their families and carers. It is convenient and reliable for patients and useful for practices. It can foster a person-centred approach to care, especially for patients with long term conditions or complex multi-morbidity. The Royal College of General Practitioners (RCGP), in collaboration with NHS England, have developed the guidance and resources in this Toolkit to help practices provide GP online services effectively, efficiently, safely and securely. The Toolkit includes clinical exemplars which demonstrate how GP online services can empower patients to take greater control of the management of their health conditions. It does not cover online consultations.
-
News ArticleGreg Price died of complications after testicular cancer surgery, but a review of his case found missed faxes, follow-ups and botched data-sharing ultimately cost the vibrant 31-year-old Alberta man his life. All the missteps in his case meant it took 407 days from his first complaint for Price — an engineer, pilot, and athlete — to be diagnosed with cancer. He died three months after his doctor said he should see a specialist, and while he was being passed between multiple doctors, his health data often was not. Now, his sister, Teri Price, says too little has changed in medical information-sharing in the decade since her brother's death. This, despite a review of his case — the 2013 Alberta Continuity of Patient Care Study — that recommended life-saving changes to the healthcare system to avoid more experiences like his. So, she's fighting to improve the system that she says not only failed her brother, but keeps failing to change. Price says that Canadians assume that their health information is shared between doctors to keep them safe and studied to improve the system, but often, it's not. And medical front-line staff in Canada say problems persist when it comes to sharing everything from patient information to aggregate medical and staffing data. "Information tends to be broken up between the services that patients attend," said Ewan Affleck, a doctor in the Northwest Territories who has spent his career fighting for better data access, and a member of the expert advisory arm of the Pan-Canadian Health Data Strategy Group. "The cohesion and use of health data in Canada is legislated to fail." Read full story Source: CBC News, 17 November 2022
-
News Article
Doctors warn failing NHS IT systems ‘undermining’ patient safety
Patient Safety Learning posted a news article in News
“Failing” IT systems in the NHS are a threat to patient safety. medics have warned. Doctors and nurses should not “tolerate problems with IT infrastructure as the norm”, according to a new editorial, published in The BMJ. Experts from Imperial College London and University College London point to an incident in which IT systems at Guy’s and St Thomas’ NHS Foundation Trust – one of the largest hospital trusts in the country – went down for 10 days. The outage, caused by the July heatwave, led to procedures and appointments being postponed for a number of patients. The new editorial highlights how IT failures can restrict services as doctors are unable to access records and are prevented from ordering diagnostic tests. This can “bring a halt to the everyday business of healthcare”, they said. The authors suggest that the NHS IT infrastructure is “crumbling” and leads to “poor user experiences” as well as patient safety incidents. “Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care – they result in patient harm and increased costs,” they wrote. Read full story Source: 10 November 2022 -
Content ArticleEarlier this year, information technology (IT) systems at one of the largest hospital trusts in the NHS stopped working for 10 days. This was the latest in a long history of NHS IT system failures across primary and secondary care. As “paperless” is now the default operating mode for many healthcare systems globally, IT failures block access to records, prevent clinicians from ordering investigations, restrict service provision, and bring to a halt the everyday business of healthcare. Increasing digital transformation means such failures are no longer mere inconvenience but fundamentally affect our ability to deliver safe and effective care. They result in patient harm and increased costs. There is a growing disconnect between government messaging promoting a digital future for healthcare (including artificial intelligence) and the lived experience of clinical staff coping daily with ongoing IT problems., writes Joe Zhang and Hutan Ashrafia in a BMJ Editorial. Digital capabilities exist in a strict hierarchy, with IT infrastructure as the foundational layer. This digital future will not materialise without closer attention to crumbling IT infrastructure and poor user experiences.
-
News Article
NHS cyber attack hits patient care with records left in ‘chaos’ three months on
Patient Safety Learning posted a news article in News
Patient care is still being undermined at NHS mental health trusts and social care providers that were hit by a major cyber attack in August, doctors have warned. Three months after the major attack wiped out NHS systems, patients’ records are missing, safety has been compromised, and medication doses are at risk of being missed amid ongoing “chaos”, i News has been told. Dr Andrew Molodynski, mental health lead at the British Medical Association, said the prolonged systems failure has damaged care because records are “integral to patients’ safety”. Mental health patients’ records and safeguarding alerts have not been available in some trusts since 4 August, when NHS software provider, Advanced, was hit by a ransomware attack which targeted its Carenotes records system. A total of 12 NHS mental health trusts have been impacted by the cyber attack, potentially impacting tens of thousands of patients as well as social care providers. According to Advanced’s own hazard log spreadsheet, seen by i News, the risks associated with disruption to its server include “medication doses missed”, “required number of carers not met”, “basic needs not met, such as nutrition and personal care”, and “health needs not met, such as wound care and physical support”. Advanced said: “We recognise that the restoration process has taken longer than we had initially anticipated and we have sought to communicate as clearly and transparently as we have been able.” It said planned dates for restoring the system for each client has been communicated directly and that the “overall restoration programme remains on track”. Read full story Source: i News, 4 November 2022 -
Content ArticleMedical records include any information about your physical or mental health recorded by a healthcare professional. This includes hospital staff, GPs, dentists and opticians. This page on The Patients Association website explains how to get copies of your medical records in England and Wales. It provides information on: How to get your GP records Using the NHS App to access records A guide to formally requesting medical records Requesting the records of someone who has died Seeing a child’s medical records Requesting the records of a vulnerable adult More information on medical records Complaints
-
News ArticleGeneral practices should delay rolling out the accelerated citizens’ access programme, due to go live on 1 November, if they have concerns over safety, the BMA has said. In guidance published on 25 October the BMA’s General Practitioners Committee said that while many practices would be able to implement the scheme before the deadline some would need more time to prepare, to ensure that they can roll it out in line with the Data Protection Act and safeguarding measures. The access scheme, led by NHS England, will automatically give patients the ability to see any new entries to their GP medical record through the NHS App. As part of safeguarding practices it will require GPs to review each record to identify any safety concerns related to providing patient access, such as in cases of domestic violence or coercive relationships. Where there are safeguarding concerns, practices can prevent patients from having automatic access by adding a specific SNOMED code to the patient’s record before 1 November 2022. David Wrigley, deputy chair of the BMA’s GP Committee for England, said, “We have a duty of care to speak up when patient safety is at risk, which is why we encourage practices even slightly unsure about whether they can deliver this programme before the start of November, to refer to our guidance. Our patients are at the heart of what we do, and we will always act in their best interests.” Read full story Source: BMJ, 26 October 2022
-
Event
Journalen 10 years anniversary conference
Patient-Safety-Learning posted an event in Community Calendar
until2022 marks the 10th anniversary of “Journalen” in Sweden. It was in 2012 that Region Uppsala first give citizens online access to their electronic health records (EHR) for the first time. Since then, a lot has happened in Sweden, and today people all over Sweden have direct online access to their EHR through the e-health service “Journalen” on 1177.se. Online access to EHRs is also highly relevant internationally, and we have also invited international researchers to Uppsala to share experiences of the implementation and effects of patients online access to records throughout the world. It will be a 2-day event with invited speakers from both the US and Europe. The conference will have a scientific focus and will also be open to the public. Conference programme Register for the conference -
News Article
IT failure disrupts patient care ‘at number of trusts’
Patient Safety Learning posted a news article in News
An IT failure has left clinicians at ‘a number of trusts’ which use the Cerner Millennium system unable to access patient records or write discharge summaries, according to an internal trust email seen by HSJ. The email, sent to staff at Barts Health Trust this afternoon, said there was a “performance issue” with Cerner PowerChart which was affecting “a number of other trusts”. The Powerchart programme is the part of the Cerner Millennium electronic patient record system used by clinicians to process document notes, request tests, view blood tests and scan reports. At least 13 trusts in the English NHS are known to use the Cerner Millennium system but it is not yet clear how many trusts aside from Barts have been affected. One clinician told HSJ the outage was “overwhelmingly unsafe” for patients. Read full story (paywalled) Source: HSJ, 11 October 2022 -
Content ArticleThis article* is an update from Dr Henrietta Hughes, Patient Safety Commissioner for England.
-
Content ArticleWeb-based personal health records (PHRs) have the potential to improve the quality, accuracy and timeliness of health care. However, the international uptake of web-based PHRs has been slow. Populations experiencing disadvantages are less likely to use web-based PHRs, potentially widening health inequities within and among countries. This study in the Journal of Medical Internet Research aimed to identify the predictors of awareness, engagement and use of the Australian national web-based PHR, My Health Record (MyHR). The study found a strong and consistent association between digital health literacy and the use of a web-based PHR. The authors suggest that improving digital technology and skill experiences may improve digital health literacy and willingness to engage in web-based PHR. They also suggest that uptake could be improved through more responsive digital services, strengthened healthcare and better social support.
-
Content ArticlePaul McGinness, chief executive, Lenus Health, presents new evidence showing how a digital service model can reduce respiratory-related hospital admissions and enable care at home.
-
Content ArticleThis article tells the story of Mr K, who died following a misdiagnosis of tension pneumothorax. Mr K was 81 and had a history of chronic obstructive pulmonary disease (COPD) and bullous emphysema. He had been diagnosed with a bulla, a large air pocket, in his right lung. The medical team treating Mr K after his admission to hospital with shortness of breath failed to review his previous x-ray and medical notes, and did not involve the respiratory team in his treatment. This led to his misdiagnosis, after which he was fitted with an unnecessary chest drain. The drain collapsed the bulla and ruptured a blood vessel leading to progressive bleeding. The medical team did not recognise their error or Mr K's bleeding and he died two days following the insertion of the drain. At his inquest, the Coroner found that the unnecessary chest drain led to Mr K's death, and that there was a missed opportunity to reassess the situation at a review the next day. They ordered that a prevention of future death report be made as the evidence heard at the inquest revealed a number of matters that gave rise to concern.
-
Content ArticleThis mixed method case study in The BMJ aimed to evaluate a national programme to develop and implement centrally stored electronic summaries of patients’ medical records. The authors found that creating individual summary care records (SCRs) was a complex, technically challenging and labour intensive process that occurred more slowly than planned. They concluded that complex interdependencies, tensions and high implementation workload should be expected when rolling out SCRs.
-
News Article
Centre has ‘lost the narrative’ over NHSE merger
Patient Safety Learning posted a news article in News
The NHS should reduce the number of different electronic patient records (EPRs) used by trusts and instead rely on a smaller set of suppliers with nationally agreed prices, according to the CEO of NHS Digital. Simon Bolton, who is also NHS England’s interim chief information officer, also said NHSD and NHSE had “lost the narrative a little bit” over their forthcoming merger, due to a “fixation” with reducing NHSE staff numbers by a third; and that the centre of the NHS remained too “autocratic and authoritarian”. Mr Bolton said there were “too many” different EPRs used in the health service and said no private sector organisation would allow such variability for so long. His comments come amid a national drive to improve the uptake and quality of EPRs across NHS providers, following new technology targets set by the government earlier this year. Read full story (paywalled) Source: HSJ, 28 September 2022 -
Content ArticleThis dashboard presents the results of a patient safety survey conducted by the European Alliance for Access to Safe Medicines (EAASM) and European Collaborative Action on Medication Errors and Traceability (ECAMET). The dashboard shows variations in different hospital-reported measures of patient safety across thirteen European countries. The questions in the survey focus on accreditation, training, electronic health records and recording, tracking and publishing of medication error data.
-
Content ArticleThe US President’s Council of Advisors on Science and Technology (PCAST) consists of individuals from sectors outside of the US Federal Government who advise the President on policy matters where the understanding of science, technology and innovation is key. This is the recording of a live-streamed meeting of PCAST, where invited speakers presented opportunities to advance scientific innovation, including improving patient safety.
