Safe and Sound: ICT services to ensure quality and safety of patient care

Lead Research Organisation: University of Edinburgh
Department Name: Sch of Informatics

Abstract

Many observers in many countries have recognised that ever increasing resources for health services do not and cannot guarantee uniformly high standards of care. Among the reasons for this are errors by individuals and failures at organisational level. These problems are extremely difficult to eradicate. Individuals and organisations simply do not have the capacity to cope with the flood of information, new medical knowledge and constant changes in policies and procedures that we see today. This problem can only get worse as research and new medical knowledge drive changes in clinical practice, and the provision of consistently high quality and safe healthcare services can only become even more difficult. ICT has an important role to play in many ways. Clinical decision support is a particularly promising technological option as it can help to improve consistency and quality of routine clinical practice where it is needed, at the point of care. There are many kinds of decision support systems ranging from simple prompts and reminders for doctors and nurses, to systems that give advice on a patient's diagnosis or treatment options, to emerging technologies that can help in the automated construction of personalised care plans. What all these systems have in common is that they help to bring together all the relevant information and current knowledge that is relevant to a patient's particular circumstances and help to make the right decision for that individual. The UK has been in the vanguard of research into the need for improvements in the quality and safety of clinical practice and the development of advanced technologies for clinical decision support and active knowledge management. Prof. Charles Vincent of Imperial College and St. Mary's Hospital is a leading expert in the reasons for medical error and other causes of adverse events . Prof. John Fox of Oxford University and Dr. David Glasspool of Edinburgh University are specialists in the design of advanced technologies for supporting decision-making and treatment planning, and have published a unique body of evidence that these technologies can make a significant contribution to improving quality and safety of care. Dr. David Robertson, also in Edinburgh, is a leading researcher in knowledge sharing in distributed, open systems.The main aims of the project are to develop a conceptual framework and technical strategy to address the key challenge of ensuring that current knowledge of best clinical practice is used in a timely and correct way in routine patient care. The project has a number of specific goals including (1) carrying out a review of the leading causes of problems in healthcare delivery that can be mitigated by using advanced information technology, and (2) demonstrating the technical feasibility of a technology which integrates the key functions of decision support, communication coordination services, and knowledge sharing and dissemination. The technical demonstrator will focus on a particular clinical exemplar, such as early detection, diagnosis and management of cancer. However, although the demonstrator will have a specific clinical focus it will be based on generic principles and reusable methods. An important outcome of the project will be an understanding of clinical, technical and socio-technical criteria by which ICT systems of these kinds may be assessed. Finally the project will publish a report that covers: the technological options for achieving the objectives of this grand challenge project; technical and socio-technical principles that must underpin development of such technologies; a road map for developing systems for improving quality and safety of clinical decision-making; more effective dissemination of new research and knowledge of best clinical practice.

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