Technology is no silver bullet for delivering error-free healthcare
By Harriet Grayson, 21/06/23
Digital health systems are transforming care across healthcare sectors, but research shows they also create new hurdles for health professionals.
Data and information sharing are crucial to making care delivery safer and more effective across hospital and aged care sectors, but switching from traditional to electronic methods is not without its drawbacks, research presented at the PCHSS Showcase: Future proofing healthcare conference has revealed.
Professor Johanna Westbrook, director of the Centre for Health Systems and Safety Research at the Australian Institute of Health Innovation (AIHI), said implementing new technology such as electronic medication management systems could significantly improve the safety and quality of care that patients receive, but could also create new problems for health professionals, especially in the implementation phase.
“We’ve got many examples demonstrating how if you can work together to share information, there is enormous power in terms of improving outcomes and care delivery, but there are also risks,” Professor Westbrook told conference attendees.
“We need a strong evidence base to ensure that these clinical information systems actually deliver better outcomes for those consumers or care providers.”
Measuring outcomes from a switch from paper medication charts to electronic systems for more than 50,000 medication orders in paediatric inpatient settings across Sydney Children’s Hospital network, Professor Westbrook and her team found that medication prescribing errors dropped by more than 30% within a year of the electronic systems being introduced.
However, no reduction in error rates was observed in the first two to three months, with errors even increasing in a few categories.
“It demonstrates that this is a risky period for organisations when you introduce these types of technology,” said Professor Westbrook.
“While clinicians realise that these clinical information systems can be fantastic and support their work, they also are a source of frustration, and we’ve also shown that they can facilitate new types of error.”
In an attempt to combat the potential frustrations and errors that might arise when introducing digital clinical information systems, Professor Westbrook and colleagues at the AIHI launched the Health Innovation Series initiative, a series of free-to-download documents that outline practical, evidence-based recommendations for using digital health systems.
So far, only the e-Medication safety series is available online, which covers topics such as prescribing an IV using an electronic medication system and editing doses with dose calculators. Professor Westbrook said additional series addressing areas such as aged care would be released soon.
Alongside her findings on implementing electronic medication systems in hospitals, Professor Westbrook also discussed a number of current research projects being undertaken by the AIHI to improve information sharing in aged care.
“We wanted to take advantage of the fact that many aged care providers are now starting to move to clinical information systems [which] creates enormous opportunities to use data more effectively to improve care and delivery,” Professor Westbrook said.
“By just extracting the data and producing descriptive contemporary data for organisations, you can provide a bit of a profile about what’s happening with residents. But we can also then apply some pretty standard statistical techniques to demonstrate to them the areas that they might want to spend a bit more effort on in terms of quality and safety.”
Using an NHMRC grant which funded the establishment of a national medication roundtable for the aged care sector, Professor Westbrook described how she and her team were working to facilitate data sharing between providers, create benchmarks for each providers’ data on medication use across their facilities, and propose initiatives to address common safety issues.
One such initiative, set to be trialled in multiple aged care facilities later this year, is a predictive analytics dashboard linking algorithms with data from clinical information systems to identify residents at risk of falls in real time, information that gets updated every 24 hours.
“In essence, what we’re trying to do is we’re trying to fast track the sector, along the analytics maturity framework … moving towards predicting what might happen for individuals, and then providing some support,” said Professor Westbrook.
“And this is where clinical information systems are incredibly valuable.”
More information on Professor Westbrook’s research can be found on the NHMRC Partnership Centre website.