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Showing results for tags 'Electronic Health Record'.
Found 130 results
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Content Article
PRSB Diabetes standards (July 2022)
Patient-Safety-Learning posted an article in Diabetes
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. -
Content ArticleClosed-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.
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Content ArticleThe 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
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News Article
NHS App to get new digital features by 2023
Patient Safety Learning posted a news article in News
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 -
News Article
USA: Cerner’s VA software rollout report cites 150 “cases of harm”
Patient Safety Learning posted a news article in News
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 -
Content ArticleThis 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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News Article
Trust branded ‘inadequate’ for leadership and maternity
Patient Safety Learning posted a news article in News
One of the trusts worst affected by coronavirus has been issued with two warning notices and rated ‘inadequate’ for leadership, following a Care Quality Commission inspection. The regulator raised serious concerns about the safety of Countess of Chester Hospital Foundation Trust’s maternity services, as well as the oversight and learning from incidents. It also found staff were experiencing multiple problems with a newly installed electronic patient record, while systems for managing the elective waiting list were said to be unsuitable. In maternity services, the inspectors flagged severe staff shortages and a failure to properly investigate safety incidents. They said there were three occasions during the inspections when the antenatal and post-natal ward was served by only one midwife, despite the interim head of midwifery saying this would never happen. Inspectors also highlighted five incidents last year where women had suffered a major post-partum haemorrhage, involving the loss of more than two litres of blood and which resulted in an unplanned hysterectomy. The CQC said two were not reported as serious incidents, and where learning had been identified from the others, action plans were not being completed on time. The CQC said it was only made aware of the incidents by a whistleblower, while internal actions agreed in December 2021 had still not been implemented two months later. Read full story (paywalled) Source: HSJ, 15 June 2022 -
Content ArticleUpdatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, Thygesen et al. aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. Their analyses illustrate the wide spectrum of disease trajectories as shown by differences in incidence, survival, and clinical pathways. The authors have provided a modular analytical framework that can be used to monitor the impact of the pandemic and generate evidence of clinical and policy relevance using multiple EHR sources.
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Content ArticleSpecialty referrals—when a clinician refers a patient to a specialist for evaluation or treatment—are on the rise in the US. Despite the introduction of electronic health records (EHRs), the referral process is often hindered by lack of clarity over roles, communication breakdowns, workloads and variations in requirements among specialists. These difficulties can lead to missed or delayed diagnoses, delays in treatment and other lapses in patient safety. This guide from the Institute for Healthcare Improvement offers recommendations that aim to help standardise how primary care practitioners activate referrals to specialists and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels, in a timely manner.
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Content ArticleThis mixed methods study in BMC Medical Informatics and Decision Making explored approaches to implementing Electronic Patient Record systems (EPRs) into NHS acute, mental health and community care hospitals throughout England. It also looked at the challenges and benefits of implementing EPRs. The authors conducted an online survey and semi-structured telephone interviews with chief information officers at NHS trusts. The study found that there was no single approach taken to implementing EPRs among participating English NHS trusts, who cited various benefits and challenges. The authors conclude that policymakers and researchers need to provide clearer guidance for trusts at various stages of implementation and ensure that intelligence is shared across England’s NHS trusts.
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Content ArticleHuge numbers of patients suffer avoidable harm in US hospitals each year as a result of unsafe care. In this blog, published in the Harvard Business Review, the authors argue that these numbers could be greatly reduced by taking four actions: Make patient safety a top priority in hospitals’ practices and cultures, establish a National Patient Safety Board, create a national patient and staff reporting mechanism, and turn on EHRs machine learning systems that can alert staff to risky conditions.
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Content ArticleThe following questionnaire will take about 8 minutes to complete and is designed to explore your professional experience of using the electronic patient record (EPR) system(s) where you work. By participating in this research, you will help the NHS understand how your EPR system is working for you, including where it is performing well and where more can be done to enhance your experience.
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Content ArticleIn this blog for BJGP Life, GP and Public Health Specialty Registrar Richard Armitage looks at the patient safety implications of changes made to gender markers on patient records. Patients in the UK are able to change the gender marker on their NHS patient record on request at any time. This action triggers the creation of a new NHS number and imports the patient’s medical information into a new patient record, without any reference to the patient's previous gender identity or original NHS number. The author highlights that failure to transfer this information could inhibit high quality care for trans patients, especially with regard to population screening programmes which invite patients according to age and gender markers on their patient record. He argues that public health officials, in collaboration with their primary care colleagues, should: respectfully communicate sex-specific health risks with their trans patients encourage them to consider requesting and accessing the appropriate population screening programmes support them in accessing screening in a dignified manner.
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News Article
Javid sets new target for trust digitisation
Patient Safety Learning posted a news article in News
Electronic patient record (EPR) systems must be implemented in at least 90% of NHS trusts by the end of next year, the health secretary has announced at HSJ’s Digital Transformation Summit. Speaking at the event with digital healthcare leaders in Birmingham, Mr Javid said an estimated one in five trusts are currently without EPR systems implemented. He said: “We have seen some brilliant progress {on digital transformation] but it’s not always been consistent across the board.” He said: “We must see these disparities as just as unjust as disparities in access to education and employment.” And added: “Electronic patient records are the essential prerequisite for a modern, digital NHS." Mr Javid said 40% of social care providers were grappling with entirely paper based records, and he also wanted them to all adopt electronic records. He also outlined the intended future of the NHS App, and the government’s ambition for this to be used by 75 per cent of adults in England by March 2024. Currently it is just over half of all adults. Mr Javid said he wanted the app to be the “future front door for interaction with the NHS”, and will be used by patients to directly communicate with their healthcare providers, to receive personalised health advice and to access test results. Read full story (paywalled) Source: HSJ, 24 February 2022 -
Content Article
Healthy data e-consultation (2022)
Patient-Safety-Learning posted an article in Data and insight
The Healthy Data e-consultation is a joint initiative run by the Belgian project 'Towards the development of a national health data platform' (AHEAD) and the European initiative 'Towards a European Health Data Space' (TEHDAS). Its aims are: to listen to citizens and patients’ views on health data secondary use and sharing, and on the role that they would like to play in the management and use of their health data. to increase citizen awareness, engagement and empowerment on the topic, so that everyone can develop informed opinions and take an active role in the use of their health data. Anyone can sign up and share their views on the following questions: What should your health data be used for? Under which conditions should your health data be used? How would you like to be informed and involved in the reuse of your health data? What other ideas do you have on health data reuse? -
Content ArticleThis blog in the Health Services Journal (HSJ) looks at the risk posed to clinical care by cyberattacks. A recent HSJ webinar in association with Sophos argued cybersecurity should be the business of everyone in the NHS, and looked at how NHS organisations can tackle the issue. Cyberattacks can cause delays and compromise patient safety and are therefore something that all healthcare staff need to consider. Using helpful language to explain the implications of cyberattacks is key to getting involvement right across the spectrum of management and frontline staff, so that it is not seen as 'an IT issue'.
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News Article
Electronic decision support ‘to be the norm for all clinicians’ under NHSE plan
Patient Safety Learning posted a news article in News
Electronic systems and clinical decision support software must become “the norm” for all NHS clinicians, under plans being drawn up by NHS England’s new transformation directorate, HSJ has revealed. The massive increase in clinicians’ use of technology forms a major part of the draft plans, seen by HSJ, with the new directorate set to launch ambitious targets for the health service. Other targets include every integrated care system creating virtual wards which are the equivalent size of a district general hospital — around 500 beds each — and installing electronic patient records at every NHS trust. The proposals are led by former US healthcare chief Tim Ferris, NHSE’s new transformation director, who was appointed last year. According to the plans, NHSE’s ambition is to increase the “safe and effective use” of computer assisted processes and clinical decision support so it becomes the “expected norm for all clinicians”. NHS leaders have welcomed the use of virtual wards to improve home care and reduce hospital occupancy, but clinicians have warned of safety issues within virtual wards, with some prominent doctors calling for a careful implementation of the policy. Read full story (paywalled) Source: HSJ, 2 February 2022 -
Event
Use of patient records and data
Patient Safety Learning posted an event in Community Calendar
This conference from the Westminster forum will examine the next steps for the use of patient records and data within the NHS and clinical research. The agenda also looks at the opportunities for improved patient engagement in their care, including through the NHS app which enables easily to access their own records. Speakers and other delegates will share experience, latest thinking on best practice, and views on the way forward for addressing key issues. Areas for discussion include: patient data use in healthcare delivery - the current landscape, and priorities for the future electronic health records - including their role in supporting integrated care systems clinical research - the next steps for utilising patient data, and developing best practice digital health - patient data collection, use and quality, and innovation priorities population health - achieving the potential of data collection to improve outcomes security - including transparency on patient data use public trust - digital health literacy and patient control of their own care plans the NHS app - its role in the future of patient-centred healthcare. Register -
Content ArticleIn this article in Inforisk Today, Marianne McGee looks at warnings from patient safety experts and federal authorities around cyberattacks on the public health sector. She looks at emerging trends in the way that cybercriminals target healthcare, recent work to bring down cybercriminal gangs and the impact of ransomware attacks on healthcare systems.
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Content ArticleThis International Patient Summary roadmap (G7-IPS) supports the G7 commitment to deliver on the rights of patients to have access to their health information, and through using open and interoperable standards it enables this information to be used at the point of treatment or care. The roadmap outlines the component parts required for implementation and the standards which will be used to ensure alignment and interoperability across the G7 community. Although developed by the G7 countries, other countries, should they wish to, will be able to adopt the same principles and use the open and interoperable resources.
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Content ArticleThis article in BMC Health Services Research looks at a range of macro, meso and micro factors influencing eHealth innovation in the English NHS. eHealth is a broad term which encompasses e-health, m-health, telemedicine and telecare, public health surveillance, personalised medicine/patient engagement, health and medical platforms, self-tracking, medical imaging, healthcare information systems, mobile connectivity, social networking, sensors and wearables, gamification, electronic health records, big data, health information technology, health analytics, digitised health systems, robotics and active assistive living. The study found that the fragmentation of the NHS is the most significant factor limiting the adoption of eHealth innovations, arguing that national policy has intensified the digital divide. It states that the NHS Long Term Plan places great emphasis on the role of digital transformation in aiding communication and enabling people to access care quickly and easily, highlighting significant implications for effectiveness, efficiency and equity.
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Content ArticleThis study, published in JAMA Network Open, looks at whether publicly reported feedback was associated with hospital improvement in an evaluation of medication-related safety performance. The results indicate that publicly reported feedback was associated with quality improvement, and the authors suggest that targeted measurement and reporting of process quality may be effective in encouraging improvement in specific areas.
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Content ArticleAlthough most current medication error prevention systems are rule-based, these systems may result in alert fatigue because of poor accuracy. Previously, we had developed a machine learning (ML) model based on Taiwan’s local databases (TLD) to address this issue. However, the international transferability of this model is unclear. This study examines the international transferability of a machine learning model for detecting medication errors and whether the federated learning approach could further improve the accuracy of the model. It found that the ML model has good international transferability among US hospital data. Using the federated learning approach with local hospital data could further improve the accuracy of the model.
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Content Article
In his newsletter today (The Top 10 Dangers of Digital Health), the medical futurist, Bertalan Meskó, raises some very topical questions about the dangers of digital health. As a huge advocate of the benefits of digital health, I am aware of most of these but tend to downplay the negative aspects as I generally believe that in this domain the good outweighs the bad. However, as I was reading his article, I realised that it was written very much from the perspective of a clinician and, to some extent, a healthcare organisation too. The patient perspective was included but not from a patient safety angle. Many of the issues that he raises do have significant patient safety issues associated with them which I’d like to share in this blog. -
Content ArticleThe world has significantly changed in the past decade and the healthcare sector has changed with it. Many healthcare organisations are now digital and digital tools enable patient safety and care. Electronic health records (EHRs) have replaced paper records. Picture archiving and communication systems have replaced film and light boxes. Computer-implemented or enabled hardware and software have replaced the mechanical systems of yesterday. In some instances, virtual visits have replaced in-person visits. And patients can transmit information about their health status and condition in real time to their clinicians via various software applications and devices. As a result of our digital transformation, electronic data is the lifeblood of the healthcare organisation. Electronic data, in the healthcare context, must be kept confidential, integrity must be preserved, and it must be made available on demand wherever and whenever it is needed. But if electronic data is not appropriately protected, clinical care and the business of healthcare can grind to a halt. This is why ransomware has been a significant concern for many healthcare organisations, as Lee Kim, Director Privacy and Security, HIMSS, explains in this article.
