National Health Service (NHS) patients' safety is at risk due to critical deficiencies in medical record keeping. A new research shows that NHS Trusts use at least 21 different electronic medical record systems, which poses a big challenge to the effective sharing of information.
The study from the Institute of Global Health Innovation (IGHI)
at Imperial College London, Improving
data sharing between acute hospitals in England: an overview of health record
system distribution and retrospective observational analysis of inter-hospital
transitions of care, was published in BMJ Open. It used a large
national-level administrative data set to identify transitions of care between
acute NHS hospital trusts.
You may also like: Radical
Interoperability As the Future of Health
The sample included 21,286,873 patients who had 121,351,837
encounters (receiving inpatient, outpatient or A&E care) at 152 trusts. Of
the latter, 35 (23.0%) were using paper records. Electronic medical records
(EMR) were used in 117 (77%) trusts, of which 92 (78.6%) had a commercially
available EMR system (21 such systems were identified in total); 12 (10.3%)
were using multiple different EMR systems; and at 13 (11.1%) tailor-made
software existed.
The survey showed that during April 2017 – April 2018 almost
4mn patients were treated at two or more hospitals with different health record
systems. Of these patients, 53.6% had encounters shared between just 20 pairs
of hospitals. Despite the hospitals’ frequent collaborative efforts to care for
individual patients, only two of these pairs used the same EMR system. The
number of cases when a hospital could not access medical data previously
recorded (either electronically or on paper) in another hospital, exceeded 11mn
(9.1%).
According to Dr Leigh Warren, clinical research fellow at
Imperial's IGHI and first author of the research, healthcare institutions and professionals
do not always have “the right information about the right patient in the right
place at the right time”. “This can lead to errors and accidents that can
threaten patients' lives. This is a complex issue, but our work shows how
existing data can be used to develop a road map towards better coordination and
safer care," he said.
EMR systems, increasingly implemented across the NHS in
recent years, are commonly expected to facilitate communication between
hospitals. The IGHI’s study, however, indicates that (a) almost a quarter of
hospitals are still using paper records and (b) for those who switched to EMR serious
interoperability challenges exist. These results are even more important
considering that a large share of patient move between different trusts but
their medical records cannot be shared effectively in the process. Furthermore,
the researchers found that among trusts that used a single system, more than
half (49) had one of three identified systems. If only these three were made interoperable,
every year for more than 1mn hospital encounters access to information would
improve.
References
Warren LR et al. (2019) Improving data sharing between acute hospitals in England: an overview of health record system distribution and retrospective observational analysis of inter- hospital transitions of care. https://bmjopen.bmj.com/content/9/12/e031637
Source: Imperial
College London
Image credit: iStock
