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Content Article
How remote patient monitoring is revolutionising patient safety
Lesley Barton posted an article in Telehealth
This article explores how remote patient monitoring (RPM) is transforming patient safety by enabling continuous, real-time tracking of health data outside clinical settings. It provides a comprehensive overview of RPM technologies, their clinical benefits, implementation challenges and best practices. It highlights the growing importance of RPM in proactive care models and its role in reducing hospital readmissions, improving medication adherence and supporting vulnerable patient populations. How is remote patient monitoring changing patient safety? A Mass General Brigham study of 10,803 participants found that RPM reduced mean blood pressure from 150/83 to 145/83, which significantly lowers cardiovascular disease risk.[1] RPM technologies provide clinicians with real-time data streams; this allows for quick interventions when patient conditions change. The continuous monitoring bridges dangerous gaps between appointments where medical complications developed undetected. Beyond crisis prevention, RPM enhances medication safety through adherence tracking and creates comprehensive longitudinal health records revealing subtle trends conventional episodic care might miss. The benefits reach vulnerable groups—elderly, rural and mobility-limited patients—who now get regular supervision free of transportation constraints, creating safety nets once inaccessible under conventional care models. Real-time monitoring: a lifeline for early intervention and patient safety RPM provides regular data collection that serves as a buffer against avoidable harm by detecting minute physiological changes that indicate clinical deterioration. RPM significantly bolsters patient safety by enabling early detection of health deteriorations, thereby facilitating timely interventions. A study published in NPJ Digital Medicine analysed 29 studies across 16 countries and found that RPM interventions led to a reduction in hospital readmissions and emergency department visits.[2] Specifically, the study highlighted that RPM demonstrated positive outcomes in patient safety and adherence, and improved patients' mobility and functional statuses. This early warning feature considerably improves patient safety by enabling timely clinical interventions before symptoms worsen. A known patient with serious congestive heart failure can also be given diuretic adjustments remotely, avoiding hospitalisation. RPM also decreases the risks associated with medications by enabling physicians to identify missed doses and adverse reactions. Long-term data further strengthens safety by showing patterns—like low oxygen levels at night in chronic obstructive pulmonary disease (COPD) patients—that single tests might miss. Personalised interventions are supported by this fine-grained understanding, especially for high-risk populations such as patients living in rural areas that have improved access to attentive monitoring. By combining speed and accuracy, RPM transforms patient safety to an actionable, data-driven and efficient procedure rather than a fixed objective. Key technologies driving remote patient monitoring: enabling safer, data-driven care Remote patient monitoring depends on a complex ecosystem of linked technology that extends clinical supervision outside of facility boundaries. Wearable devices form the basic foundation of this system—with regulatory-approved sensors capturing vital metrics continuously. RPM is transforming healthcare by shifting from reactive to proactive safety strategies. These digital systems continuously track vital signs, medication compliance and physiological parameters outside traditional clinical settings. This enables early detection of deterioration before serious complications arise. Advanced cardiac monitors identify arrhythmias with 98% accuracy and smart glucose sensors provide real-time glycaemic information via subcutaneous readings. Connected devices for tracking urinary patterns help physicians diagnose various types of incontinence without requiring in-person assessments, improving dignity and convenience for patients with mobility challenges. Smart inhalers with embedded sensors record medication usage patterns and technique, enabling precise interventions for respiratory conditions. Mobile applications are a link between patients and clinical teams—with simple dashboards that show health trends and medication adherence. These platforms usually combine clinical protocols, secure messaging systems and alerts based on preset thresholds. Backend analytics platforms transform raw physiological data into clinically relevant insights through sophisticated algorithms. These systems analyse longitudinal data against established baselines to detect minor abnormalities that precede clinical deterioration. According to studies, these predictive capacities can detect sepsis 6–12 hours earlier than traditional approaches, considerably increasing survival rates.[3] Secure, Health Insurance Portability and Accountability Act (HIPAA) compliant electronic health record (EHR) integration—using end-to-end encryption and strict authentication—creates comprehensive patient profiles, enabling better-informed treatment decisions. Implementing remote patient monitoring: main challenges RPM has numerous benefits in healthcare, but putting it into practice involves challenges that need thoughtful solutions. Digital literacy gaps create accessibility barriers, particularly among elderly populations where only 64% report comfort with technology-based healthcare tools according to the Journal of the American Geriatrics Society survey of 3,450 seniors.[4] Privacy concerns are significant as continuous monitoring generates sensitive health data that requires strong security. To maintain patient trust while meeting regulatory standards, healthcare centres must use end-to-end encryption, unambiguous consent mechanisms and transparent data governance frameworks. Another problem is clinical workflow integration; RPM systems that function without the use of EHR platforms result in documentation silos. Customised integration pathways that embed remote monitoring data within regular clinical interfaces are required for successful RPM implementation. When clinicians get an overwhelming number of notifications, the intended safety benefits are undermined. Effective systems use tiered alert processes with tailored thresholds that are based on patient baselines rather than population norms. These graduated notification systems ensure that important notifications receive necessary attention while preventing frequent low-risk alerts. As healthcare organisations face these issues, good implementation frameworks that include technical assistance, privacy safeguards and workflow optimisation are relevant to fulfilling RPM's full potential. Best practices for patient-centered remote monitoring Effective RPM is beyond technological equipment; it requires an effective structure that can only come from consistent planning and review. Healthcare organisations should establish dedicated implementation teams comprising clinicians, IT staff and patient advocates to gather diverse viewpoints and boost adoption of RPM. This cross-functional strategy improves RPM acceptance and sustainability while lowering possible resistance. Healthcare administrators should train providers thoroughly on both technical use of medical devices and data interpretation. A 2023 NEJM Catalyst study of 76 healthcare centres showed that centres with robust training of healthcare professionals had 43% higher RPM use after a year compared to those with minimal training.[5] Healthcare professionals should also be trained to focus equally on patient support through easy enrolment, clear instructions in multiple languages and in-person device training. Dedicated tech support channels should be created for RPM users in order to prevent frustration whenever there is a network glitch. Clear clinical protocols defining intervention thresholds, escalation pathways and response timeframes should be made to transform data into actionable intelligence. Rigorous quality assurance measures—including regular connectivity testing, data validation audits and patient usability assessments—safeguard programme integrity. Periodic review cycles examining alert frequency, response times and intervention outcomes help refine system parameters for maximum clinical utility. The most effective RPM programmes integrate patient feedback mechanisms allowing continuous refinement of interfaces, alert frequencies, and educational materials based on real-world experience. Conclusion RPM is improving healthcare from reactive to preventive care. As technology advances, these systems will become standard practice. Future developments will include smaller sensors, longer battery life and better connectivity—making monitoring easier for patients while improving data quality. Better predictive analytics will help physicians identify health problems earlier with greater accuracy. Beyond helping patients, RPM is changing organisational safety culture by expanding care beyond hospitals. This shift represents a major advancement—creating continuous monitoring systems that protect patients throughout their healthcare journey and redefining patient safety for modern medicine. References 1. Mass General Brigham. Mass General Brigham Remote Healthcare Delivery Program Improves Blood Pressure and Cholesterol Level, 9 November 2022. 2. Ying Tan S, et al. A systematic review of the impacts of remote patient monitoring (RPM) interventions on safety, adherence, quality-of-life and cost-related outcomes. NPJ Digital Medicine 2024; 7: 192. 3. King J, et al. Early Recognition and Initial Management of Sepsis in Adult Patients. Ann Arbor (MI): Michigan Medicine University of Michigan, 2023. 4. American Geriatrics Society 2024 Annual Scientific Meeting. Journal of the American Geriatrics Society 2024; 72: III-VI. 5. Barrett JB, et al. Reduced Hospital Readmissions Through Personalized Care: Implementation of a Patient, Risk-Focused Hospital-Wide Discharge Care Center. NEJM Catal Innov Care Deliv 2025;6(6). DOI: 10.1056/CAT.24.0420. Further reading on the hub Putting patients at the heart of digital health Digital diagnosis—what the doctor ordered? Electronic patient record systems: Putting patient safety at the heart of implementation How do we harness technology responsibly to safeguard and improve patient care?- Posted
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Content Article
Examples of how two NHS trusts have designed a virtual ward using the system-wide digital healthcare platform, Luscii. The team at Maidstone and Tunbridge Wells NHS Trust (MTW) in collaboration with the Home Treatment Service (HTS) have designed a virtual ward to cater for frailty patients, allowing them to provide acute-level care without the need for hospital admission. MTW’s innovative approach means patients are empowered to live fuller and freer lives with access to hospital care from the comfort of their own homes. Maidstone and Tunbridge Wells NHS Trust_ Frailty Case Study.pdf Nurses at London North West University Healthcare NHS Trust (LNWH) have created a virtual ward caring for hundreds of heart failure patients. The new virtual heart failure ward is a fascinating case study of the power and potential for technology to optimise the use of critical resources and improve care outcomes. The Future of Care - Inside LNWH's Virtual Heart Failure Ward (1).pdf- Posted
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England is likely to need between 23,000 and 39,000 more hospital beds by 2030/31. Providing hospital care in people’s homes could be a practical alternative to building more NHS facilities, helping to reduce risks and improve efficiency. There have been high expectations of remote monitoring as a key element of NHS England’s virtual ward (otherwise known as “Hospital at Home”) programme. But its use on virtual wards caring for people with frailty has been low compared with other virtual wards. The reasons why remote tech monitoring hasn’t had such high uptake on frailty wards aren’t clear – so THIS Institute set out to find out. This study looks at the views and experiences of people involved in virtual wards – for example as health professionals, managers, policymakers, or evaluators. The project was guided by a patient and public involvement group. What the study found There were four main challenges with using remote monitoring in virtual wards for frailty care: Healthcare professionals weren’t sure about the benefits of remote monitoring for people with frailty. Some people said that that remote monitoring would require significant changes in how patients, carers, and staff worked. The right tools and technology weren’t always available, and products needed to be improved to give frail patients and virtual wards better support. Virtual wards differed greatly in operation and use of remote monitoring, making comparison difficult. Standardisation efforts were sometimes viewed as unhelpful, and the balance between standardisation and local flexibility wasn’t always right. Although using remote monitoring has been a major goal of the NHS virtual wards programme, this study highlights several of the key challenges in making it work for frail patients. If technology is going to work, the solutions will need to be co-designed with input from patients, carers, and staff who care for patients with frailty across different health and social care sectors.- Posted
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News Article
UK online pharmacies face stricter rules for sales of weight-loss jabs
Patient Safety Learning posted a news article in News
Access to weight-loss jabs through online pharmacies is to be tightened up as part of a crackdown on inappropriate prescriptions – although some experts say even more must be done. Weight-loss injections such as Wegovy, which contains the drug semaglutide, and Mounjaro, which contains the drug tirzepatide, have boomed in popularity after trials showed they can help people lose significant amounts of weight, with many people seeking private prescriptions. However, concerns have been raised that the medications are being inappropriately prescribed through online pharmacies to people who do not meet the criteria for them. A Guardian investigation previously revealed some online pharmacies operating in the UK have approved and dispatched private prescriptions of the jabs to people of a healthy weight, as well as to those who have lied about their weight to meet criteria for a prescription. Now the general pharmaceutical council (GPhC), which regulates pharmacists, pharmacy technicians and pharmacy premises in England, Scotland and Wales, has said it is tightening the rules. The changes mean pharmacies can no longer base decisions about online prescribing of weight-loss jabs – or other high-risk medications such as antimicrobials, laxatives and opioids – on the information provided in an online questionnaire alone, as some online pharmacies have done previously. Instead, such information must be verified independently. Read full story Source: The Guardian, 4 February 2025- Posted
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News Article
New York doctor sued for prescribing abortion pills to Texas woman
Patient Safety Learning posted a news article in News
A lawsuit, filed by Texas attorney general Ken Paxton on Thursday, alleges Dr Margaret Carpenter unlawfully prescribed abortion-inducing drugs to the 20-year-old, in violation of the state's laws. While no criminal charges are involved, Mr Paxton said the woman, who was nine weeks pregnant, was taken to hospital in July with "serious complications" after taking the medication. "In Texas, we treasure the health and lives of mothers and babies, and this is why out-of-state doctors may not illegally and dangerously prescribe abortion-inducing drugs to Texas residents," he said. Court papers note the woman received two drugs commonly used in abortions for pregnancies up to 10 weeks: mifepristone, which blocks a vital hormone in pregnancy, and misoprostol, which causes contractions, cramping and bleeding in the uterus. The documents add the state of Texas is seeking up to $250,000 from New York's Dr Carpenter - who is also a co-founder of the Abortion Coalition for Telemedicine. The lawsuit says the medic's "conduct violates the Texas Health and Safety Code's prohibition on prescribing abortion-inducing drugs via telemedicine". Such prescriptions are made online and over the phone. Texas bars abortion at all stages of pregnancy, and in 2021 - before the Supreme Court repealed Roe v. Wade, which gave a constitutional right to abortion - passed a law allowing state citizens to sue anyone who provides abortions or assists someone in undergoing the procedure. Read full story Source: Sky News, 15 December 2024 -
Content Article
This US cohort study looked at whether the shift from face-to-face to virtual mental health service delivery is associated with the risk of suicide-related events. The results suggest that offering virtual mental health care in addition to in-person care may reduce suicide-related events.- Posted
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When the Covid-19 pandemic started, video consulting became standard practice for many GPs, who became rapidly acquainted with the technology for video calls. Doctors worked on improving their video consulting technique, not knowing for how long they might have to limit in-person consultations. Now that vaccination has reduced the risks of face-to-face appointments, the vast majority of GP practices rarely use video consultation, and fewer than 1% of consultations were conducted this way in England in May 2023. In this BMJ article, GP Helen Salisbury looks at the reasons for this decline in the use of video calls, arguing that face-to-face consults allow for a more accurate and safe diagnostic process and facilitate building rapport between healthcare professionals and patients.- Posted
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Event
ECRI has released its newest list of the Top 10 patient safety concerns confronting healthcare organisations. Healthcare providers, regardless of their practice setting, can start with our Top 10 list and use it to guide their own discussions about patient safety and improvement initiatives. This top 10 report highlights patient safety concerns across the continuum of care because patient safety strategies increasingly focus on collaborating with other provider organizations, community agencies, patients or residents, and family members. Each patient safety concern on this list may affect more than one setting. Join ECRI to learn more about the identified concerns and how your organisation can begin to address them. Register- Posted
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until2020 saw a huge leap in the delivery of virtual health and care, with encouraging lessons for the current crisis and beyond. But has the speed of innovation been at the expense of inclusive people and patient-centred care? In this free online event from the King's Fund, explore what we can learn from the innovations that have accelerated during the pandemic and how we can align patient and user involvement in the development of future virtual health and care solutions. Register- Posted
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News Article
Telemedicine saves chronic pain patients time and money
Patient Safety Learning posted a news article in News
Patients who saw a pain medicine specialist via telemedicine saved time and money and were highly satisfied with their experience, even before the COVID-19 pandemic, according to a study presented at the ANESTHESIOLOGY® 2020 annual meeting. Results of the study confirm many chronic pain patients are confident they will receive good care via telemedicine, while avoiding lengthy commutes and time spent in traffic. "This era of contactless interactions and social distancing has really accelerated the adoption of telemedicine, but even before the pandemic, patient satisfaction was consistently high," said Laleh Jalilian, M.D., lead author of the study and clinical assistant professor at the University of California, Los Angeles (UCLA). "Patients who are being evaluated for new conditions may be better off having office visits initially. But once patients establish a relationship with providers, follow-up visits can occur efficiently with telemedicine, while maintaining patient rapport and quality outcomes. We believe 50% of our visits could be conducted via telemedicine." "Now that telemedicine is more widespread, it may become a valued part of care delivery in chronic pain practices," said Dr. Jalilian. "Clearly many patients benefitted from remote consultations and follow-up appointments using telemedicine. We hope it will encourage policymakers and insurance providers to continue to support these platforms and inspire more innovation in this developing field of research and patient care." Read full story Source: EurekAlert, 5 October 2020- Posted
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News Article
Need for tech to reduce medication error and improve patient safety
Patient Safety Learning posted a news article in News
Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here -
News Article
All GP consultations should be remote by default, says Matt Hancock
Clive Flashman posted a news article in News
All GP appointments should be done remotely by default unless a patient needs to be seen in person, Matt Hancock has said, prompting doctors to warn of the risk of abandoning face-to-face consultations. In a speech setting out lessons for the NHS and care sector from the coronavirus pandemic, the health secretary claimed that while some errors were made, “so many things went right” in the response to Covid-19, and new ways of working should continue. He said it was patronising to claim that older patients were not able to handle technology. The plan for web-based GP appointments is set to become formal policy, and follows guidance already sent to GPs on having more online consultations. But the Royal College of GPs (RCGP) hit back, saying it would oppose a predominantly online system on the grounds that both doctors and patients benefited from proper contact. Read full article here- Posted
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Babylon apology after GP app lets patients see other people's consultations
Patient Safety Learning posted a news article in News
Babylon Health is investigating whether NHS patients were among those affected by a 'software error' that allowed people registered with its private GP service to view recordings of other people's consultations earlier this month. Babylon Health has confirmed that a small number of patients were able to view recordings of other patients' consultations earlier this week. The issue came to light after a patient in Leeds who had access to the Babylon app through a private health insurance plan with Bupa reported that he had been able to view around 50 consultations that were not his own. The patient told the BBC he was 'shocked' to discover the data breach. "You don't expect to see anything like that when you're using a trusted app," he said. "It's shocking to see such a monumental error has been made." Babylon told GPonline that the app used by private and NHS patients is the same, but it had yet to confirm whether the roughly 80,000 patients registered with the company's digital first NHS service GP at Hand were among those affected. The problem is understood to have cropped up when a new feature was introduced for patients who switched from audio to video mid-way through a consultation. Read full story Source: GPOnline, 10 June 2020- Posted
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The Remote by Default research study, a collaboration between the Universities of Oxford and Plymouth and the Nuffield Trust, has been exploring how technology can be harnessed to support excellent primary care. Using workshops, interviews, and focus groups of clinicians, service users, and other stakeholders, they have begun to map the multiple interacting influences on the choice of consultation modality.- Posted
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This Rapid Evidence Scan from Moore et al. examined the effectiveness of virtual hospital models of care. While no reviews evaluated a complete model, tele-healthcare only and tele-healthcare with remote telemonitoring interventions demonstrated similar or significantly better clinical or health system outcomes including reduced hospitalisations, readmissions, emergency department visits and length of stay, compared to usual care, including those delivered without home visits or face-to-face care. The use of the Internet showed mixed but promising results. The strongest evidence was for cardiac failure, coronary heart disease, diabetes and stroke rehabilitation. Nurses played a central role in home visiting, providing telephone support and education. However, the studies were heterogenous and the results should be interpreted with caution.- Posted
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The Doctor Will Zoom You Now was a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The project was led in partnership with Traverse, National Voices and Healthwatch England and supported by PPL. The study engaged 49 people over 10 days (June 22nd – July 1st 2020) using an online platform, with 20 additional one to one telephone interviews. Participants were also invited to attend an online workshop on the final day of the study. Using insight from the key findings from the research, this website provides useful tools and tips for getting the most out of your appointment.- Posted
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This article describes how 55 international and national participants participated in an event that focused on strengthening patient safety within telemedicine through resilience on 16 August 2018 at the Health Innovation Centre of Southern Denmark in Odense, Denmark. -
News Article
Royal Surrey County Hospital to launch virtual ward to free up beds
Patient Safety Learning posted a news article in News
The Royal Surrey County Hospital is preparing to open its first virtual ward. From this summer 15 patients will receive treatment at home using apps and wearable technology, as an alternative to a stay in hospital. The ward will be overseen by a consultant, working with therapists, nursing staff and pharmacists. The hospital, in Guildford, plans to extend the ward to 52 patients by April 2024. Health providers across England have been asked to deliver virtual wards at a rate of 40 to 50 beds per 100,000 people by December 2023. It is hoped they will free up beds more quickly, speeding up admissions from A&E and for elective surgery. Read full story Source: BBC News, 7 June 2022- Posted
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NHS will not hit virtual wards target, internal data suggests
Patient Safety Learning posted a news article in News
The NHS is on trajectory to fall short of a flagship pledge to have around 24,000 “virtual ward beds” in place by December 2023, internal data has revealed. NHS England’s figures from March, seen by HSJ, suggest the system is instead more likely to have created around 18,500 virtual beds by the 2023 deadline. Senior clinicians, including the Royal College of Physicians and the Society of Acute Medicine, have recently raised concerns about the speed and timing of the roll-out and staffing implications. And now fresh concerns are also being raised about the programme following publication of a new academic study which suggests virtual wards set up by the NHS during Covid made little impact on length of stay or readmissions rates. Alison Leary, professor of healthcare and workforce modelling, London South Bank University, was one of the first senior leaders to publicly voice concerns about the NHS’s virtual wards programme. Professor Leary told HSJ: “I am not surprised [systems are falling] short. Since Elaine [Elaine Maxwell, visiting professor, London South Bank University] and I published our piece in HSJ, I have been contacted by several clinicians who have serious concerns over virtual wards and staffing them.” Read full story (paywalled) Source: HSJ, 31 March 2022- Posted
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Clinical negligence claims are often built upon a lack of adequate documentation of what was said and allegations that patients have not been properly counselled about risks and alternatives. Elizabeth Thomas explores in this HSJ article what this means for the increasingly significant role of telemedicine and the steps which can go a long way in reducing the burden on patients and the public purse- Posted
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The results of Digital Health Intelligence’s first survey of CNIO Network members provides a ’state of the nation’ insight into nursing and allied health professional leadership in healthcare IT. This webinar offers a chance to learn about some of the key findings of the survey and to hear from senior nursing figures on their thoughts about what it means for where we go next. This webinar will be of interest to: anyone currently working in a nursing/allied health professionals (AHP) clinical informatics role those who aspire to develop their career in this area those who are seeking to set up such a role within their organisation those currently working with CNIOs/AHP informatics leads. Attendees will learn: more about how CNIO/AHP informatics roles are currently set up in the NHS – time commitment, reporting structures etc what the profile is of those holding such roles about possible challenges in connections between CNIOs/AHPs in informatics roles and CCIOs and CIOs thoughts on whether the CNIO/AHP informatics role should be formally recognised further views from senior leaders on the future of these roles.- Posted
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Telemedicine and telephone-triage may compromise patient safety, particularly if urgency is underestimated. This paper from Haimi et al., published in BMC Medical Informatics and Decision Making, aimed to explore the level of safety of a paediatric telemedicine service, with particular reference to the appropriateness of the medical diagnoses made by the online physicians and the reasonableness of their decisions.- Posted
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The rise of telehealth (2 September 2020)
lzipperer posted an article in Telehealth
Telehealth has become more entrenched as a healthcare provision mechanism in response to COVID-19. This Dissent Magazine article cautions its effectiveness long term due to its potential to be established as a profit centre for healthcare organisations. -
Content Article
Telemedicine has potential to address inequity in healthcare but not until certain barriers are addressed. This article from Joanna Pearlstein in Wired discusses how physicians and care organisations have to be creative and rely on partnerships and local resources, such as school district hot spots or public library broadband access, to make the system reliably work for all their patients.- Posted
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In this month's Letter from America, Lorri Zipperer discusses cautions and capabilities associated with healthcare technologies. Letter from America is a Patient Safety Learning blog series highlighting new accomplishments and patient safety challenges in the United States. This is Lorri's last blog in the series and we'd like to thank Lorri for sharing her insights with us over the last 12 months. Read here all the Letter from America blogs I had been trying to get my Mom to do video calls on her computer for a decade. Pushback and inexperience with new technologies just didn’t give her the confidence she needed to step over that line. A lack of trust in the systems to work right and in her ability to navigate the hiccups minimised her willingness to give it a shot. And then along came covid. Due to necessity and front-line assistance (my sister and niece get a hat tip here), Mom finally began to see how beneficial the tools were for improving her state of mind and increasing our awareness of how she is from a long distance during the lockdown. There also has been hesitancy in healthcare to fully embrace communication technologies that can optimise and energise processes. Uncertainty and optimism are certainly warranted in the use of electronic mobile connections in healthcare and the devices that support it. These new approaches touch facets of training, appointments, personal health monitoring and overall system reliability. Beyond the changes necessitated by the pandemic, the need to embrace new technologies in healthcare is now essential and will be for the future despite expected challenges to universal adoption. The covid pandemic has motivated healthcare to broaden its vision of the potential for remote technologies. Now telemedicine, telehealth, telecoaching, digital therapeutics and mobile patient outreach has become absolutely necessary. They are here to stay. Changes in reimbursement policies have provided coverage for telehealth services that, before the pandemic, was much more restrictive. While patients and physicians may appreciate the convenience of this “new normal”, there are quandaries associated with its uptake. At a time when relationships are so vital to our lives, having technology to either build them (granted in a new way), inform them (via a new set of communication tools) or damage them (dependent on the willingness, system robustness and comfort of the individuals involved) is worth considering. For example, worries about diagnostic accuracy, limitations of the virtual physical exam, concerns about privacy, usability and the loss of the person-focus of patient/physician communication. The effectiveness of telemedicine and telehealth is also impacted by health literacy, access to reliable networks and patient comfort with using digital tools. Physicians and care organisations have to be creative and rely on partnerships and local resources, such as school district hot spots or public library broadband access, to make the system reliably work for all their patients. On another level, Dissent Magazine discusses a range of economic concerns stemming from the accelerated adoption of telehealth, including the primary worry that services have the potential to be structured as profit centres shifting the focus of decisions toward stakeholder and executive compensation rather than effective care. Then there are questions surrounding the apps and tools patients are using to make decisions about their health. Dr. Google has known weaknesses. Patient-facing diagnostic apps, wearables and symptom trackers, while showing promise still require appropriate risk evaluation before patients should fully trust them to track and manage their health without clinician guidance, and protect against worry and overuse of health services. The Skeptical Cardiologist shares reasons to resist the temptation to rely on, for example, the blood oxygen monitoring accuracy of a much anticipated product for reasons that include lack of reference to primary data and cost. Use of symptom trackers could proliferate as patients remain hesitant to visit physicians due to covid concerns. One project from Georgetown University was forthcoming about its rapid development strategy when sharing the results of a covid symptom tracker pilot test. Areas covered included size of the beta test (48 students), use of unique identifiers to address privacy concerns for both patients and organisations involved, access to condition-relevant patient-centered educational information and instructions to seek medical care should symptoms indicate that necessary step. It is this sort of transparency that aids the healthcare community and patients to appropriately select and trust tools to manage symptoms and situations for public and personal health safety. Voice activation technologies, so convenient for getting the latest news and listening to music, are seen as having great potential in healthcare monitoring as well. Voice characteristics are being explored as a diagnostic indicator. As covered recently in Nature, vocal biomarkers can track mental status, pulmonary function and coronary distress. But a myriad of factors could affect verbal characteristics reducing voice as a reliable mechanism for diagnosis. While promising, teasing out these differences in vocal diagnostics is still an emerging opportunity being explored in the US and around the world. Also, the use of voice-activated technologies in certain care settings can impact the privacy of the patient and may therefore not be suitable. On a systemic scale, the growing dependance on technologies leave patients, clinicians and organisations vulnerable to purposeful or accidental incidents or outtages, such as cyberattacks, that create disruptions and compromise patient safety. Recently a large health system in the US was crippled due to a ransomware attack. Patients needed to be rapidly moved to another out of system facility to ensure their safety. Experts caution that this is not the last of these situations and advise systems to train their staff and create awareness to recognise the early signals of a cyberattack to quickly reduce the extent of the damage and corresponding interruptions to healthcare services. Mom is now expanding her use of technology to make life better. She is exploring her first streaming service and becoming comfortable with its capabilities to binge on popular programmes. Who knows if that will lead the way to virtual visits with her cardiologist, or being able to track her vital signs from across the country and her personal use of a smart watch to monitor her heart? Let’s hope for all moms and other patients the adoption of technologies in the health space can be folded into our daily lives with minimal harm and negative disruption.- Posted
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