The Commission contributes to e-Health safety by optimising safety and quality in the rollouts of digital clinical systems. It focuses on hospital medication management programs and discharge summaries, and uses e-Health initiatives to improve the safety and quality of health care, including antimicrobial stewardship.
e-Health safety programs and resources
The Commission’s e-Health safety programs include:
- Certification framework for digital mental health services
- Cumulative, hospital-level antibiogram
- Electronic discharge summary (EDS) systems
- Electronic medication management (EMM) systems in hospitals
- My Health Record clinical safety program
- My Health Record in emergency departments project
- National guidelines for on-screen display of medicines information
- Safety Issues at Transitions of Care: Pain points relating to clinical systems
- Structured microbiology requests and reporting of healthcare-associated infections
The Commission works in collaboration with states and territories, the private hospital and primary care sectors, the Australian Digital Health Agency (the Agency), and other national bodies to promote the safety and quality agenda within national digital programs.
e-Health literature reviews
The Commission appointed Sydney University to develop a literature review The Impact of Digital Health on Safety and Quality of Health Care. The review analyses evidence for the types of digital health interventions which have been shown to improve health care. It focuses on the safety and quality impact of five digital health interventions:
- Clinical decision-support systems (CDSSs)
- Computerised provider order entry (CPOE) including electronic prescribing
- Electronic patient portals
- Electronic patient reminders (mobile technologies)
- Information-sharing at discharge (electronic discharge summary or EDS).
The findings from the literature review will support jurisdictions, the Agency, and other healthcare providers to identify best-value approaches to digital health initiatives.
HIT-related patient safety incidents
Literature on the clinical safety of health information technology (HIT) systems is rapidly evolving as these systems roll out. The Commission asked the Australian Institute of Health Innovation at Macquarie University to perform a literature review and environmental scan on approaches to the review and investigation of Health IT-related patient safety incidents to:
- Identify appropriate methods for monitoring hazards affecting HIT systems
- Investigate incidents resulting from the use of these systems.
A Literature review and environmental scan on approaches to the review and investigation of Health IT-related patient safety incidents found that the requirements for HIT safety systems:
- Are similar to those that apply to existing patient safety systems
- Should include the ability to identify hazards ahead of time and permit review of incidents after the event
- Should also provide information about the prevalence of incident reporting and management systems
- Should allow the opportunity to classify and report on incidents to ensure a continuous open loop of feedback and improvement.
The review noted that numerous methodologies exist and that no single method was appropriate to detect, investigate and classify all HIT incidents. Successful HIT safety systems need to have in place a multidisciplinary team with appropriate skill sets from a clinical, health informatics and system safety perspectives and use a tailored approach to investigate HIT patient safety incidents.