Latest digital health blog: guest blog from Dr Philip Scott, University of Portsmouth

Katie Cheeseman: Hopefully, some of you will have had the opportunity to read our last digital health blog, featuring Laurence Pearce the CEO at XIM. I am equally delighted to pass the reins over this week to Dr Philip Scott, from the School of Computing at Portsmouth University. Take it away, Philip!

Can “digital medicine” improve patient care?

Medical error is the third leading cause of death in the USA! Over a quarter of a million people die each year in US hospitals due to mistakes in their care [1]. Many of these cases relates to medication: prescribing, dispensing and administration. Worrying error levels have also been found in NHS hospitals and GP prescribing [2]. And of course, patients often do not take their medicines as planned – nearly half of patients choose not to keep up advised medication within ten days of a prescription [3].

Can the miracle of IT fix these problems? Not on its own! The 2016 SIHI conference (Southern Institute of Health Informatics) at the University of Portsmouth last month was sponsored by Wessex AHSN and focussed on how digital technology can help, but in the context of professional standards, education and behaviour change. Here are a few of the highlights...

We were reminded that IT is not a magic bullet. If the software is not good enough or if it is implemented badly, it can make things even worse – in one well known case even being implicated in higher child mortality rates [4].

How far do NHS hospitals still have to go with electronic prescribing? Ann Slee from NHS England updated us on the Digital Medicines strategy, showing how variable progress is to date. Each CCG area is developing its digital roadmap for progress towards the ‘paperless 2020’ targets – time will tell how far the available funding and organizational capacity will take us.

What can the retail sector offer? We heard from Gary Warner about PharmOutcomes – a nationally available system for community pharmacies that also provides data for audit and public health interventions, such as targetted medication advice for patients who are prescribed NSAIDs or who have acute kidney injury. The data showed good effects on reducing hospital admissions.

Amanda Cooper from Portsmouth Hospitals NHS Trust showed how innovative use of the national Summary Care Record and the Hampshire Health Record has made huge efficiency improvements for inpatient medicines reconciliation, but research supported by Wessex AHSN demonstrated how many junior doctor mistakes there are that need to be corrected in this vital process.

Ultimately, it is safer behaviour by clinicians and patients that will improve outcomes. Jeremy Wyatt from the University of Southampton showed how understanding the psychological, social and environmental factors of behaviour can make IT interventions more effective.

If we can get it right, “digital medicine” should mean better, safer care.

Presentations from the conference are online at: http://sihi.port.ac.uk/sites/2016/programme/

References

[1] http://www.bmj.com/content/353/bmj.i2139

[2] https://www.england.nhs.uk/wp-content/uploads/2014/03/psa-sup-info-med-error.pdf

[3] http://www.rpharms.com/promoting-pharmacy-pdfs/helping-patients-make-the-most-of-their-medicines.pdf

[4] http://pediatrics.aappublications.org/content/116/6/1506