In the complex and high-stakes environment of healthcare, accurate and reliable data is not just beneficial—it is essential for patient safety. As hospitals increasingly transition to digital systems, the importance of data integrity, accessibility, and usability becomes even more critical.
We will explore why data matters to patient safety, how hospitals often get IT systems wrong, and what MBI does to prevent these issues, using real-world examples and insights from recent investigations.
The Critical Role of Accurate Data in Patient Safety
Accurate data is the backbone of effective healthcare delivery. It informs clinical decisions, ensures continuity of care, and supports the management of patient outcomes. In the context of elective services, precise data collection and analysis enable healthcare providers to prioritise cases based on urgency, allocate resources efficiently, and maintain transparent communication with patients. Incorrect data leads to incorrect decisions, delayed treatments and compromised patient care. This ultimately exacerbates health inequalities and undermines patient trust.
Despite significant investment, including nearly £900 million over the past two years to upgrade IT systems, many NHS trusts are still experiencing major issues with their EPR systems. This includes interoperability problems and inadequate testing, which have been highlighted as ongoing concerns.
Examples of Harm from IT Failures
Recent reports have underscored the severe consequences of IT failures in the NHS. According to a BBC investigation, computer system issues have been linked to the deaths of three patients and over 100 instances of serious harm across various NHS hospital trusts in England. These incidents highlight how critical it is for IT systems to function correctly and reliably.
For instance, Darnell Smith, a 22-year-old with sickle cell disease and cerebral palsy, died after his vital signs were not monitored as required due to his personal care plan being inaccessible in the hospital’s computer system. This tragic outcome underscores the importance of ensuring that electronic patient records (EPR) are fully functional and that critical patient information is always accessible to healthcare providers.
In another case, Emily Kate Harkleroad’s death was attributed to the failure of a newly implemented Cerner IT system at University Hospital of North Durham, which did not identify her as critically ill. This delay in recognising her condition resulted in her not receiving the necessary blood-thinning treatment for a blood clot, ultimately leading to her death.
In addition to these tragic individual cases, the wider picture is equally frightening:
- 89 Trusts confirmed they monitored and logged instances when patients could be harmed because of problems with their Electronic Patient Record (EPR) systems
- almost half of hospitals recorded instances of potential patient harm linked to their IT systems
- nearly 60 Trusts reported IT problems that could affect patient care
- more than 200,000 letters were not sent across 21 trusts
- there were 126 instances of serious harm linked to IT issues, across 31 trusts
Why is implementing IT in the NHS so difficult?
Healthcare is the most complex industry in the world. On the one-hand, HealthTech companies who claim to have quick-fixes don’t understand the challenges. On the other hand, the NHS too often looks for the easy answer rather than doing things properly. However, more broadly there are several key issues that need to be handled better by both parties:
- Diverse Stakeholder Needs
Healthcare environments involve a wide array of stakeholders including doctors, nurses, administrative staff, and patients, each with different needs and workflows. Balancing these varying requirements within a single IT system is challenging. Systems must accommodate clinical precision, administrative efficiency, and user-friendly interfaces while ensuring patient data privacy and security. Too often the systems themselves are not designed with each of these user groups in mind.
- Integration with Existing Systems
Healthcare facilities often have a mix of legacy systems and newer technologies that need to work together seamlessly. Ensuring interoperability between disparate systems such as EPR, laboratory information systems, and imaging systems is critical but difficult. Poor integration leads to data silos, making it hard to access comprehensive patient information, which can compromise patient safety. How many Imaging systems exist in the NHS with no link back to the EPR? Way too many.
- Data Security and Privacy Concerns
Healthcare data is highly sensitive, and protecting it is paramount. IT systems must comply with strict regulations like GDPR in Europe and the UK. Ensuring data security involves implementing robust encryption, access controls, and continuous monitoring to prevent breaches, which adds layers of complexity to the implementation process.
- High Stakes and Regulatory Compliance
As we have seen, errors in healthcare IT systems can have severe consequences, including patient harm or death. Therefore, these systems must undergo rigorous testing and validation to meet regulatory standards. Compliance with healthcare regulations requires extensive documentation and adherence to protocols, which can slow down implementation. The NHS is frankly terrible at testing, which allows HealthTech vendors to get away with not meeting their obligations.
- Complex workflows
Healthcare workflows are inherently complex and vary significantly between different departments and specialties. IT systems must be highly customisable to fit these specific workflows without adding unnecessary burdens. Customisation can be costly and time-consuming, making it a significant challenge. The NHS also must recognise that standardising as many workflows as possible lowers risk of IT systems – nowhere near enough effort is placed on standardisation.
- User Adoption and Training
Healthcare professionals often face demanding schedules, and adding new IT systems can initially disrupt their workflow. Effective training programs are essential to ensure that staff can use the new systems efficiently. However, resistance to change and the learning curve associated with new technology can hinder user adoption. I have yet to see a successful training programme for a new EPR.
- Financial Constraints
Implementing and maintaining advanced IT systems require significant financial investment. Healthcare organisations, especially those within public sectors like the NHS, often operate under tight budgets. Balancing cost with the need for up-to-date, effective IT systems is a major challenge. How many times has the training budget been slashed on an EPR implementation?
Risk Mitigation
Books could be written on each of the reasons for difficulty implementing IT in healthcare. However, the NHS should immediately focus on 6 key areas to be improve upon:
- Comprehensive Assessments: Conducting thorough needs assessments to tailor IT solutions to specific requirements. Don’t just buy EPIC or Cerner without understanding what your user needs are and how whatever product you choose meets or does not meet each of those requirements. (no product will meet them all)
- Workflow Standardisation: Increasing the numbers of workflows that have been standardised. If you are thinking of implementing a new EPR, this work should start two years out from a Go-Live, perhaps even before you’ve chosen a supplier.
- Enhanced Testing: Whatever you have budgeted for testing, double it. Develop in-house testing capability to hold suppliers to account.
- Robust Training Programs: Ensuring all users are adequately trained to minimise resistance and ease the transition. FUND IT PROPERLY.
- Advanced Technology Integration: Using tools like the MBI’s LUNA Explorer for real-time monitoring of systems and workflows to maintain high standards of patient care.
- Strong Data Governance: Implementing frameworks and testing to ensure quality data which complies with regulatory standards.
In conclusion, while the implementation of IT systems in healthcare settings is fraught with challenges, these can be mitigated through comprehensive planning, user-centric design, and robust data management practices.
These efforts are critical for enhancing patient safety, improving care delivery, and ensuring operational efficiency in healthcare environments.
