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Found 124 results
  1. News Article
    No patient data held by mental health trusts was taken following a cyber attack this summer, NHS England has confirmed. The regulator told HSJ it had received confirmation from tech firm Advanced, which was the subject of a cyber attack in July, that no data had been breached on its Carenotes electronic patient record. The EPR is used by around a dozen mental health trusts. The process of reconnecting trusts fully back to Carenotes also started this week, after providers spent two months with limited or no access to their EPR. HSJ previously revealed that senior NHS chiefs feared patient data may have been taken or accessed by those responsible for the cyber attack, who issued ransom demands to Advanced. Since then, experts have been brought in to investigate any potential data impact following the attack. Read full story (paywalled) Source: HSJ, 21 September 2022
  2. Content Article
    A digital transformation is underway in healthcare and health technology. But what exactly do the smart hospitals of the future look like? Are we heading for a fully virtual health experience? Whether it’s AI and machine learning, or another form of innovation – it’s clear to see that health tech, and healthcare, is changing drastically. The words “smart hospital” and “virtual hospital wards” have eased their way into our vocabulary – and they will soon be the driving force of healthcare everywhere. So what would smart hospitals look like? And what should we be expecting between now and 2050? Health Tech World asked some of the leading experts in the field to give us their predictions as well as their expertise on what the healthcare of the next few decades will look like.
  3. Content Article
    Naaheed Mukadam and colleagues investigated the incidence of diagnosed dementia and whether age at diagnosis and survival afterward differs among the UK's three largest ethnic groups. They used primary care electronic health records, linked Hospital Episode Statistics and mortality data for adults aged ≥65 years. They compared recorded dementia incidence 1997–2018, age at diagnosis, survival time and age at death after diagnosis in White, South Asian, and Black people. The study found that dementia incidence was higher in Black people. South Asian and Black people with dementia had a younger age of death than White participants and Black participants. The authors concluded that South Asian and Black peoples’ younger age of diagnosis and death means targeted prevention and care strategies for these groups should be prioritised and tailored to facilitate take-up.
  4. Content Article
    Hardeep Singh, an informatics leader, patient safety advocate and innovator has been awarded the Individual Achievement Award in the 20th John M. Eisenberg Patient Safety and Quality Awards for demonstrating exceptional leadership and scholarship in patient safety and healthcare quality through his substantive lifetime body of work. Eric Thomas speaks to Hardeep in an interview for the Joint Commission Journal on Quality and Patient Safety.
  5. Content Article
    With patients increasingly being able to view their healthcare records online or via an app, it is very important that they understand what their records say. This webpage by the NHS explains what some of the most common medical abbreviations mean, to help patients understand what has been written about their care and treatment.
  6. Content Article
    The SAFER Guides consist of nine guides organiaed into three broad groups. These guides enable healthcare organisations to address electronic health record (EHR) safety in a variety of areas. Most organisations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern.
  7. News Article
    Doctors say it could take months to process mounting piles of medical paperwork caused by a continuing cyber-attack on an NHS supplier. One out-of-hours GP says patient care is being badly affected as staff enter a fourth week of taking care notes with pen and paper. The ransomware attack against software and services provider Advanced was first spotted on 4 August. The company says it may take another 12 weeks to get some services back online. Dr Fay Wilson, who manages an urgent-care centre in the West Midlands, says the main choke point for her team is with patient records. She said it could affect patient care "because we can't send notifications to GP practices, except by methods that don't work because they require a lot of manual handling, and we haven't got the staff to actually do the manual handling". Read full story Source: BBC News, 31 August 2022
  8. Content Article
    Processes relating to communication between healthcare professionals are complex and vulnerable to breakdown. In the electronic health record (EHR)-enabled healthcare environment, providers rely on technology to support and manage complex communication processes, and if implemented and used correctly, EHRs have potential to improve safety. This clinician communication self-assessment guide aims to help healthcare professionals determine how safe their practice is in relation to electronic health records (EHR) and communication.
  9. Content Article
    This study in JAMA Network Open aimed to investigate how often patients who read open ambulatory visit notes perceive mistakes, and what types of mistakes they report. The results of the study showed that: 1 in 5 patients who read a note reported finding a mistake 40% perceived the mistake as serious the most common mistakes reported were mistakes in diagnoses, medical history, medications, physical examination, test results, notes on the wrong patient and sidedness. The authors suggest that patients may perceive important errors in their visit notes, and inviting them to report mistakes may be associated with improved record accuracy and patient engagement in safety.
  10. News Article
    Mental health trusts continue to suffer much disruption after a cyber attack left them unable to access their electronic patient records. Several trusts which use Advanced’s CareNotes EPR are grappling with the system being down, although the company said on Friday some progress had been made to restore the EPR. One source at an affected mental health trust said there had been “not much in the way of improvements”, while another said they feared it could be “months” before they can fully access the EPR. NHS England’s mental health director Claire Murdoch is regularly raising issue nationally, HSJ was told, as response teams work with Advanced to investigate and restore IT systems, which were taken offline after the company was hit by a cyber attack two weeks ago. Hereford and Worcestershire Health and Care Trust has told its patients they might have to “provide more detail on your medical history to ensure clinicians have the most up-to-date information”, while Oxford Health Foundation Trust warned the technical issues could cause delays to patient care. Read full story (paywalled) Source: HSJ, 21 August 2022
  11. Content Article
    In this blog, Charlotte Clayton, midwife and clinical advisor at the Organisation for the Review of Care and Health Apps (ORCHA), explores how providing the right training and support for maternity staff is key to seeing the benefits tech can bring to quality of care and workload.
  12. News Article
    Criminals have issued ‘demands’ to an NHS IT supplier targeted by a cyber attack, leading health chiefs to fear they have accessed confidential patient data, HSJ has learned. IT firm Advanced was targeted last week. The company provides electronic patient records to several trusts and most NHS 111 providers. Multiple government agencies – including the National Crime Agency and GCHQ – are now working to identify the extent of the damage caused by the attackers, while leaders of affected mental health trusts have warned of a “pretty desperate” situation as staff are unable to access vital patient records. In a statement issued last night, Advanced said: “With respect to potentially impacted data, our investigation is under way, and when we have more information about potential data access or exfiltration, we will update customers as appropriate.” Read full story (paywalled) Source HSJ, 11 August 2022
  13. News Article
    A cyber attack that has caused a major outage of NHS IT systems is expected to last for more than three weeks, leaving doctors unable to see patients’ notes, The Independent has learned. Mental health trusts across the country will be left unable to access patient notes for weeks, and possibly months. Oxford Health Foundation Trust has declared a critical incident over the outage, which is believed to affect dozens of trusts, and has told staff it is putting emergency plans in place. One NHS trust chief said the situation could possibly last for “months” with several mental health trusts, and there was concern among leaders that the problem is not being prioritised. In an email to staff, Oxford Health Foundation Trust chief executive Nick Broughton, said: “The cyber attack targeted systems used to refer patients for care, including ambulances being dispatched, out-of-hours appointment bookings, triage, out-of-hours care, emergency prescriptions and safety alerts. It also targeted the finance system used by the Trust." The NHS director said: “The whole thing is down. It’s really alarming…we’re carrying a lot of risk as a result of it because you can’t get records and details of assessments, prescribing, key observations, medical mental health act observations. You can’t see any of it…Staff are going to have to write everything down and input it later.” They added: “There is increased risk to patients. We’re finding hard to discharge people, for example to housing providers, because we can’t access records.” Read full story Source: The Independent, 11 August 2022
  14. News Article
    Hospital passports need to be more consistently used across the NHS to better support patients with communication difficulties, a learning disability nurse says. Support for patients with communication needs and learning disabilities, as well as the nurses caring for them, is often ‘inconsistent’, according to RCN professional lead for learning disabilities Jonathan Beebee. Coupled with the current system-wide pressure of patient backlogs and high staff vacancy rates it means patients often do not have their communication needs met. A hospital passport, which contains vital information about a patient’s health condition, learning disability and communication needs, would help address this, Mr Beebee told Nursing Standard. "There has got to be better consistency in how we are identifying people with communication needs, how they are getting flagged and how nurses are being pointed to that from the second that someone is admitted to the ward," he said. Mr Beebee says ensuring a standardised approach would improve patient experience and ultimately nurses’ relationship with patients. Read full story Source: Nursing Standard, 27 July 2022
  15. News Article
    A whistleblower has warned a London hospital is "literally in meltdown" after its IT system was knocked out during last week's heatwave. Operations at Guy's and St Thomas' Hospital in Lambeth were cancelled after its IT servers broke down in 40C (104F) temperatures on 19 July. A doctor told the BBC "poor planning" and "chronic underfunding" meant issues remained a week later. A spokesperson for the hospital said IT issues were "having an ongoing impact". Without a functioning IT system, staff have returned to paper notes, the doctor said. The anonymous whistleblower, who works as a doctor at Guy's and St Thomas', said this meant "we see very worrying results, but we don't know where the patients are so we spend ages tracking them down". "We cannot read any historical notes from patients. Names are being misspelt, so scans are not showing up. "Each morning, someone hand-delivers a stack of test results to the ward. In there, we received several patient results that don't belong to our ward," the doctor said. "If we don't recover our shared drives, we risk losing months of research data, if not years." Read full story Source: BBC News, 27 July 2022
  16. News Article
    One of the NHS’s biggest hospital trusts is facing major problems after its IT system failed because of the extreme temperatures earlier this week. Guy’s and St Thomas’ trust (GSTT) in London has had to cancel operations, postpone appointments and divert seriously ill patients to other hospitals in the capital as a result of its IT meltdown. The situation means that doctors cannot see patients’ medical notes remotely and are having to write down the results of all examinations by hand. They are also unable to remotely access the results of diagnostic tests such as X-rays and CT and MRI scans and are instead having to call the imaging department, which is overloading the department’s telephone lines. GSTT has declared the problem a “critical site incident”. It has apologised to patients and asked them to bring letters or other paperwork about their condition with them to their appointment to help overcome doctors’ loss of access to their medical history. One doctor at GSTT, speaking on condition of anonymity, said: “This is having a major effect. We are back to using paper and can’t see any existing electronic notes. We are needing to triage basic tests like blood tests and scans. There’s no access to results apart from over the phone, and of course the whole hospital is trying to use that line. “Frankly, it’s a big patient safety issue and we haven’t been told how long it will take to fix. We are on divert for major specialist services such as cardiac, vascular and ECMO.” Read full story Source: The Guardian, 21 July 2022
  17. Content Article
    Timely written communication between primary and secondary healthcare providers is paramount to ensure effective patient care. In 2020, there was a technical issue between two interconnected electronic patient record (EPR) systems that were used by a large hospital trust and the local community partners. The trust provides healthcare to a diverse multiethnic inner-city population across three inner-city London boroughs from two extremely busy acute district general hospitals. Consequently, over a four-month period, 58,521 outpatient clinic letters were not electronically sent to general practitioners following clinic appointments. This issue affected 27.9% of the total number of outpatient clinic letters sent during this period and 42,251 individual patients. This paper from Patel et al. describes the structure, methodological process, and outcomes of the review process established to examine the harm that may have resulted due to the delay.
  18. News Article
    A new patient medical records system at a Spokane Veterans Affairs hospital in the US has caused nearly 150 cases of patient harm, according to a federal watchdog agency. An inspection by the VA Office of the Inspector General (OIG) found that a new Cerner electronic health record (EHR) system, now owned by Oracle, failed to deliver more than 11,000 orders for specialty care, lab work and other services at Mann-Grandstaff VA Medical Center, the first VA facility to roll out the new technology. The OIG review found that the new EHR sent thousands of orders for medical care to an undetectable location, or unknown queue, instead of the intended care or service location, effectively causing the orders to disappear without letting clinicians know they weren't delivered. The intent of the unknown queue is to capture orders entered by providers that the new EHR cannot deliver to the intended location because the orders were not recognized as a “match” by the system, according to the VA watchdog. From facility go-live in October 2020 through June 2021, the new EHR failed to deliver more than 11,000 orders for requested clinical services. Those lost orders, often called referrals, resulted in delayed care and what a VA patient safety team classified as dozens of cases of "moderate harm" and one case of "major harm." The clinical reviewers conducted 1,286 facility event assessments and identified and classified 149 adverse events for patients. Read full story Source: Fierce Healthcare, 20 July 2022
  19. News Article
    Patients are at risk of a missed cancer diagnosis due to a reliance on paper records, an NHS trust has admitted after a man died due to his tumour being overlooked. Michael Lane, 50, from Shrewsbury, was “failed” by Shrewsbury and Telford Hospital Trust, his family has said after his cancer scan result was misplaced leaving him with a growing kidney tumour for 10 years. The trust is yet to fully launch an electronic record system a year after an investigation into Mr Lane’s death warned other patients were at risk due to the gap in paper records. Mr Lane went into Shrewsbury and Telford Hospital for a scan following a referral for suspected cancer in 2011. The radiographer flagged a small tumour but the scan was overlooked, placed within his paper records and never reported as being a concern. In an investigation report carried out by the trust in May 2021, seen by The Independent, the hospital admitted that had his tumour been seen and operated on earlier he may have survived. The report also admitted there were ongoing risks within the trust due to gaps in its electronic records system. It said: “The implementation of an IT solution will not prevent sad cases such as that of Mr Lane where the scan report that was missed took place before the widespread availability of such systems, however, it is clear that until we have an electronic requesting and sign-off system we remain at risk of new cases of missed results and harm occurring as a result of the ongoing reliance of paper-based results.” Read full story Source: The Independent, 17 July 2022
  20. Content Article
    People with diabetes are increasingly using medical devices to help manage their condition, including devices for monitoring glucose and delivering insulin. However, healthcare professionals are finding that they cannot always access up to date information about a person with diabetes and the data from their medical devices. This makes it harder to provide the best advice and support. The Professional Record Standards Body (PRSB) was commissioned by NHS England and NHS Improvement to produce two standards for sharing diabetes information between people and professionals across all care settings, including self management data from digital apps and medical devices (for example, continuous glucose monitors). The Diabetes Information Record Standard which 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. The Diabetes Self-Management Standard which defines information that could be recorded by the person (or their carer) at home (either using digital apps or medical devices) and shared with health and care professionals.
  21. Content Article
    Closed-loop communication—when every test result is sent, received, acknowledged and acted upon without failure—is essential to reduce diagnostic error. This requires multiple parties within the healthcare system working together to refer, carry out tests, interpret the results and communicate them in language the patient can understand. If abnormal test results are not communicated in a timely manner, it can lead to patient harm. This Quick Safety case study looks at the case of a 47-year-old school teacher who had a screening mammogram. The radiologist identified a suspicious area of calcifications, which required follow up. The patient’s GP was not on the same electronic medical record (EMR) as the imaging centre and, because of front office changes, missed the notification to follow up. The patient was told that the radiologist would contact her if the results were abnormal and therefore assumed she was okay. A year later when seeing her GP, the patient was told that she needed follow-up testing and that she had stage 3 cancer. Her lesion had grown significantly, and she now required surgery, chemotherapy and radiation for advanced breast cancer. The case study suggests safety actions that should be considered to prevent this error from happening again.
  22. Content Article
    The health and social care system’s long-term sustainability depends on effective digital transformation. This document outlines the government's plans to reform and develop the use of digital technologies in health and social care in order to deliver a system that will be faster, more effective and more personalised. The plan pulls together the four goals of reform for the health and care system identified by the Secretary of State for Health and Social Care: prevent people’s health and social care needs from escalating personalise health and social care and reduce health disparities improve the experience and impact of people providing services transform performance
  23. News Article
    The NHS App will soon be updated with features to help offer people in England more personalised care. It is part of the government's plan for a digital revolution to speed up care and improve access while saving the health service time and money. By March 2023, more users will receive messages from their GP and be able to see their medical records and manage hospital elective-care appointments. By March 2024, the app should offer face-to-face video consultations. The government's ambition is for at least 75% of adults to be using it by March 2024. Currently, less than half - about 28 million - have it on their phone or tablet. The government also wants 90% of NHS trusts to have electronic patient records in place or be processing them by December 2023 and for all social-care providers to adopt a digital social-care record. And patients across the country should be able to complete their hospital pre-assessment checks from home by September 2024. Read full story Source: BBC News, 29 June 2022
  24. News Article
    A serious revelation may derail the Cerner Millenium rollout. A draft report by the Department of Veterans Affairs (VA) Office of Inspector General (OIG) states that a flaw in Cerner’s software caused the system to lose 11,000 orders for specialty care, lab work, and other services – without alerting healthcare providers the orders (also known as referrals) had been lost. This created ‘cases of harm’ to at least 150 veterans in care. The VA patient safety team classified dozens of cases of “moderate harm” and one case of “major harm.” The major harm cited affected a homeless veteran, aged in his 60s, who was identified as at risk for suicide and had seen a psychiatrist at Mann-Grandstaff in December 2020, after the implementation. After prescribing medication to treat depression, the psychiatrist ordered a follow-up appointment one month later. That order disappeared in the electronic health record and was not scheduled. The consequences were that the veteran, weeks after the unscheduled appointment date, called the Veterans Crisis Line. He was going to kill himself with a razor. Fortunately, he was found in time by local first responders, taken to a non-VA mental health unit, and hospitalized. The draft report implies that the ‘unknown queue’ problem has not been fixed and continues to put veterans at risk in the VA system. There may be as many as 60 other safety problems. Other incidents cited in the draft report include one of “catastrophic harm” and another case the VA told the OIG may be reclassified as catastrophic. Catastrophic harm is defined by the VA as “death or permanent loss of function.” Read full story Source: Telehealth and Telecare Aware, 21 June 2022
  25. Content Article
    This book is a resource for the coaches who provide health IT-related assistance for primary care practices to support their QI and practice transformation efforts. The audience for this handbook includes both the health IT-focused coaches who support QI work as well as the practice facilitators/coaches who have the necessary background, interest, and skills to provide clinical health IT support. Although the handbook is primarily intended for external coaches working with primary care practices, the content could also be useful for practice-based staff responsible for addressing health IT needs related to QI. The handbook assumes readers already have a basic level of comfort with EHR use and with extracting and using electronic data for QI.
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