Conservatives often told me when I was campaigning in Witney that they have already been helping their children with student loans, accommodation during and post uni or house deposits, but they didn’t realise that soon their children will want help with medical bills too.
The NHS is not overspent, it is underfunded. The Treasury have clawed back billions over the last five years. If you don’t want the horrors of private insurance system, if you want hospitals with well paid, safe staffing, the best clinical care for all (not a lucky few), the best opportunities for research to develop new treatments and continue to improve care, please have your say – just 5 questions.
This is the LAST DAY to respond to the NHS consultation that was kept secret. If you want the NHS to exist:
Some people, especially in households with more than 1 person may be axed from the electoral register next week due to “government process changes”
It takes 5 mins or less
Register here https://www.gov.uk/register-to-vote
This series has attempted to go back and dig around in the roots of technology and health information systems thinking and higlight where it has had an impact on the NHS. Health informatics appears to brush over some of the complex issues which make it into review papers when things don’t go as planned. Human health is not designed to be in perpetual beta whilst technologists develop continuous software versions and systems thinking to be inflicted on them – not unless there are appropriate clinical trial methodologies and a sound clinical evidence base supporting it.
Books recommendations (from other designers)
A book by Stephen Few : Information dashboard design : the effective visual communication of data http://www.worldcat.org/title/information-dashboard-design-the-effective-visual-communication-of-data/oclc/63676286
Edward Tufte books: http://www.edwardtufte.com/tufte/index
There are not enough articles about the use of health information systems or health technology and patient safety for all the reasons previously mentioned in this series. The reviews of the NHS Programme for IT and NIHR also highlight these issues. The 2011 US Institute of Medicine paper provides examples – incorrect data leading to wrong patients with wrong diagnosis, wrong notes, wrong drug dosages which harm and in some cases kill patients. So a full circle has been turned, the claims that IT systems will revolutionise healthcare are flawed and complex – like humans. Added to the commercial reasons in a marketised healthcare system:
Several reasons health IT–related safety data are lacking include the absence of measures and a central repository (or linkages among decentralized repositories) to collect, analyze, and act on information related to safety of this technology.
Another impediment to gathering safety data is contractual barriers (e.g., nondisclosure, confidentiality clauses) that can prevent users from sharing information about health IT–related adverse events. These barriers limit users’ abilities to share knowledge of risk-prone user interfaces, for instance through screenshots and descriptions of potentially unsafe processes. In addition, some vendors include language in their sales contracts and escape responsibility for errors or defects in their software (i.e., “hold-harmless clauses”).The committee believes these types of contractual restrictions limit transparency, which significantly contributes to the gaps in knowledge of health IT–related patient safety risks…
…when instances that either cause or could result in harm occur, there is no authority to collect, analyze, and disseminate learning. Lack of sufficient vendor action to build safer products, or regulatory requirements to do so, threatens patient safety…Users need to share information about risks and adverse events with other users and vendors. Legal clauses shifting liability from vendors to users discourage sharing.1
The paper encouraged the private sector to take leadership so very slow if at all implementation of addressing patient safety issues, with health IT in the US being the biggest threat to patient safety in 2014 with a list based on “more than 300,000 event reports, research requests, and root-cause analyses submitted to ECRI’s patient-safety organization2”
Clinical leadership is essential with reporting, analysing and improving patient safety. The GMC guidelines are clear:
If patients are at risk because of inadequate premises, equipment* or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance and your workplace policy. You should also make a record of the steps you have taken.
All doctors have a duty to raise concerns where they believe that patient safety or care is being compromised by the practice of colleagues or the systems, policies and procedures in the organisations in which they work. They must also encourage and support a culture in which staff can raise concerns openly and safely.
You must not enter into contracts or agreements with your employing or contracting body that seek to prevent you from or restrict you in raising concerns about patient safety. Contracts or agreements are void if they intend to stop an employee from making a protected disclosure.*3
The attached table shows a list of some of the Health IT / technology companies who are known to have NHS contracts and links from the excellent HealthCareRenewal and DuckDuckWeb blogs which detail in some cases thousands of bugs and errors with the systems, also the revenue that the companies are making. This isn’t about bashing IT companies, this is an essential need for transparency and commercial failure which leads to patient harm or even death. MHRA and FDA could add health information systems into the health technologies regulation and oversight processes.
Final post in this series to follow in about an hour
1. IOM (Institute of Medicine). 2012. Health IT and Patient Safety: Building Safer Systems for Better Care. Washington, DC: The National Academies Press, available at http://www.nap.edu/catalog/13269/health-it-and-patient-safety-building-safer-systems-for-better
2. Terry K (2014), Health IT Biggest Threat to Patient Safety, Report Says, Medscape Medical News available at http://www.medscape.com/viewarticle/824109
3. GMC (2012), Raising and acting on concerns about patient safety, General Medical Council, available at http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp
In case of interest, these are the signatories I’ve managed to find from the Dossier of Concerns,
Ross Anderson Ross.Anderson@cl.cam.ac.uk
Brian Randell firstname.lastname@example.org
James Backhouse email@example.com
David Bustard https://www.linkedin.com/in/david-bustard-a019895
Ewart Carson firstname.lastname@example.org
Patrik O’Brian Holt email@example.com
Roland Ibbett firstname.lastname@example.org
Ray Ison email@example.com
Achim Jung A.Jung@cs.bham.ac.uk
Uday Reddy U.S.Reddy@cs.bham.ac.uk
Peter Ryan firstname.lastname@example.org
Geoffrey Sampson email@example.com
Martin Shepperd firstname.lastname@example.org
Tony Solomonides https://www.linkedin.com/in/tony-solomonides-2690739
Ian Sommerville email@example.com
Frank Land firstname.lastname@example.org
Bev Littlewood email@example.com
John A McDermid firstname.lastname@example.org
Julian Newman email@example.com
Harold Thimbleby firstname.lastname@example.org
Martyn Thomas email@example.com