PATIENT SAFETY
been widely adopted as the defacto medical imaging standard, PACS vendors continue to use proprietary extensions to make interoperability within and outside the enterprise complicated and costly. This problem is compounded when organisations try to incorporate specialty images that fall outside traditional PACS parameters. This is hardly an insignificant amount of patient information. Today, experts agree that a majority of healthcare data is stored outside the EMR system. The “missing” content includes DICOM and non-DICOM imaging data like video and photos, as well as clinician notes, discharge orders, personal health data and other file types the PACS cannot manage. As a result, this rich clinical content becomes silos of data, scattered throughout the organisation and inaccessible from the EMR. Point-of-care imaging is also a pressing challenge as more and more clinical images and video content are captured on mobile devices, portable hard drives and removable storage cards. Think portable ultrasounds, dermatology cases, wound care and ophthalmology images. This practice potentially breeches patient confidentiality and certainly creates clinical ‘blind spots’, because the content is not included in the patient’s permanent digital health record. If clinicians cannot view imaging and specialty assets from the EMR, they are not obtaining a complete picture of their patients. Healthcare can no longer afford this lack of transparency and its associated costs. The best enterprise imaging solution is one that can be implemented in a phased approach, facilitating the removal of silos where possible and building bridges to those that must remain for the time being. Such a system should have widespread support. Most clinicians do want to have full
access to their patients’ data, and they should be an asset in the delivery of an effective patient-centred data sharing platform. However, all too often, IT changes are feared and resented because of the way they are rolled out without appropriate consultation. Arguably, even consultation alone is not enough, and would do healthcare organisations a disservice. In a staff base that is eager to bring the benefits of digital health to patients, the sector has a huge asset. It can use those practitioners to help design and build a system that truly works for everyone, because the nature of the healthcare sector means that practitioners will have patients’ interests at heart too. Introducing any new IT system is more than just a technical challenge: the whole programme should be about developing new ways of working that are designed around the clinician, and all stakeholders should be closely involved in the development process. Once the project and management teams are confident they have staff onside and a clear understanding of how and why clinicians use information sharing systems, they can target an outcome that directly improves work within the organisation. That end state should be at the heart of driving implementation. For example, when Hyland Healthcare developed a zero-footprint viewer and streaming technology to help improve the diagnosis of stroke patients, it worked with clinicians to understand their working practices and needs. What emerged was a remotely accessible system to view CT scans, whereby clinicians could use their mobile phones to securely access data, and make an immediate decision to thrombolyse or not – potentially saving lives. By focusing on the clinical outcomes, and understanding the way clinicians work, a system was
devised that ultimately benefitted patients. This bottom-up approach to technology development and implementation lends itself to small-scale projects. The lessons learned and systems developed can then be scaled up once problems have been ironed out and successful features identified. This requires a shift in management culture: no longer will the biggest departments be targeted first in the hope of a large-scale impact. Instead, those departments with the best opportunities for success and useful innovation – often smaller teams - receive technology at an early stage and help develop systems which in the long term will have a better take-up and deliver bigger results across the organisation. When it comes to identifying and
nurturing teams or departments that will be willing ambassadors and testers of an organisation’s IT solutions, it is useful to have close contacts with frontline staff. Every project should have a clinical champion who can bring the clinical perspective to the table, providing representation for stakeholders and advising on patient interests too. The RCN has rightly volunteered nurses and midwives to play a role in this process. Undoubtedly, many physicians, radiologists, and other specialty practitioners are also keen to develop the digital health solutions which we all believe can help make healthcare even better despite budget and demographic challenges over the coming decades. These professionals are a significant asset, which management should embrace and empower to build the interconnected IT system everyone needs.
References
1
https://www.rcn.org.uk/news-and-events/news/ digital-transformation-of-health-care-must- involve-nurses
CSJ
The NEW Smartsigns Compact 300 Series SPOT Check Vital Signs Monitor...
Flexible, reliable and affordable
• Non Invasive Blood Pressure • Pulse Oximetry • Temperature (optional)
For more information visit:
www.huntleigh-diagnostics.com @Huntleighdiag Huntleigh Healthcare
029 2048 5885 Huntleigh
NOVEMBER 2018
WWW.CLINICALSERVICESJOURNAL.COM I
71
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88
