Concern for patient safety with e-records
A call for national e-health clinical safety governance
Principles for national e-health clinical safety governance
- E-health clinical safety governance must be national but independent of government or industry, to avoid conflicting interests that may lead to resisting change for commercial, professional or political reasons. It must be expert-based rather than organisationally representative.
- Safety is an emergent property of a whole system. Certification of individual components does not guarantee that the whole system is safe.
- E-health clinical safety governance should integrate with mainstream patient-safety processes. Harms arise from sequences of events involving both technical and non-technical elements.
- Governance must assure all components are safe, both alone and in combination with pre-existing elements. Standards and regulatory processes such as accreditation should underpin this, with full legislative backing.
- The safety of the whole system must be monitored in routine use to detect potential risks and actual harm events, as well as clusters. Open disclosure should be paramount.
- Governance must build defences against harm, including safety processes, system redundancies and training, to minimise unsafe use or the creation of unsafe settings.
- Any governance body must have a capability to investigate, analyse and act upon significant risks in the system.
Again we see the lack of leadership and governance in the Australian e-Health effort is being seen for what it is - utterly inadequate.
More evidence on all this over the next few days.