The latest addition to the National Patient Safety Strategy focuses on the digital technologies that have surged in popularity during the pandemic. Digital solutions have become integral to how care is run in clinical settings as well as being utilised to keep patients out of the hospital and provide preventative care. However, their rapid adoption has meant that, in some cases, speed of implementation may have taken precedence over safety.
The strategy is a collaboration between NHSX, NHS Digital and NHS England and NHS Improvement and aims to improve the safety of current and future digital health technologies and promote their use in solving patient safety challenges.
Patient safety in a changing healthcare landscape
Survey results show that 97% of UK adults who received NHS during the pandemic used technology in their interaction with the health service. Engagement with technology in the healthcare space is rapidly increasing, and so is concern about patient safety. Dr Natasha Phillips, Chief Nursing Information Officer and Director of Patient Safety, spoke about the ever-evolving nature of patient safety:
‘While we aim to provide the safest care every day, safety is not just a product of our individual actions. It is the result of the environments we work in, the tools we have at our disposal and the culture around us. …More than ever, [this] requires a dedicated focus on digital technologies, which are increasingly integral to our health and care service.’
Digital solutions have the potential to save lives and radically revolutionise care pathways, but they also carry risks if not properly managed and secured. In light of this, ‘we have a responsibility to ensure that the digital technologies that surfaced with such vigour during the pandemic not only have a positive legacy, but are sustained and improved upon for patients, carers and families.’
Unsafe care remains among the leading causes of death worldwide. ‘While the NHS is seen as a leader in patient safety, rates of harm across services remain unacceptably high, and cross-sector commitment is needed to establish open and transparent safety cultures.’ The exact amount of harm associated with digital systems is hard to quantify, in part due to underreporting of patient safety incidents, which is a complex problem that obscures precise metrics. Ironically, the thing that is likely to make this digital harm reporting more efficient is digital systems themselves; it is only through capturing and analysing detailed data that patterns and anomalies will be found.
In many ways, digital solutions make for safer care: they reduce the risk of human error, allow providers to spot challenges early, and have vast infection control benefits. In other ways, they carry risks: data breaches, data loss during updates and moves between systems, and system errors that could have direct negative impacts on patient wellbeing.
Minimising the risks is an important task that the new Digital Clinical Safety Strategy aims to address. The national commitments for digital safety are as follows:
- ‘Collect information about digital clinical safety […] and use it to improve system-wide learning.
- Develop new digital clinical safety training materials and expand access to training across the health and care workforce.
- Create a centralised source of digital clinical safety information, including optimised standards, guidelines and best practice blueprints.
- Accelerate the adoption of digital technologies to record and track implanted medical devices through the Medical Devices Safety Programme.
- Generate evidence for how digital technologies can be best applied to patient safety challenges.’
Ultimately, these measures aim to ensure that the technologies used in health and care are safe, staff are familiar with how to use them safely, and they are then used to improve patient safety.
Digital technologies to improve patient safety
Digital solutions have demonstrably improved patient safety from a multitude of angles. Scanning technologies that are used to track data and devices have reduced device and patient identification errors, digital interventions have been effective in reducing medication errors, and remote monitoring technologies are demonstrating the potential to recognise early signs of deterioration.
On a wider scale, electronic health records support patient safety through reliable access to shared information, ensuring that providers are always looking at the most up to date information about a patient’s care and wellbeing.
‘Digital clinical safety is not simply about recording harm reactively, it is also about learning and preventing it proactively,’ comments the NHS. This can be done through the use of predictive analytics platforms such as the one created by RwHealth, or through remote patient monitoring and personalised patient-facing predictions such as those provided by Eleven Health.
Whilst the pandemic has accelerated the adoption of digital solutions in healthcare, it did not start it. These solutions have existed for some time, but it is only due to their rapid growth in the past 18 months that the need for a strategy such as this has become apparent and the inherent security concerns of digital healthcare systems are being so thoroughly addressed.
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