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Angela

Angela Ryan

Year of Award: 2017 Award State: New South Wales Health And Medicine > General
To investigate methods for preventing patient harm through national digital health safety governance - UK, Canada, USA
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Recommendations:

In making these recommendations I draw on the opportunities presented through the overall findings and principles articulated above, which dovetail with the principles as originally defined by Coiera and colleagues. I also draw on the premise of the ‘Health Information Technology (HIT) Safety Center’ (the Centre) model developed in the USA. I do this in part as it is the only fully elaborated model supported by an extensive evidence base, the structure of which is informed by learnings beyond the USA borders . 

The Centre was originally recommended by the Institute of Medicine (IOM) Report Health IT and Patient Safety: Building Safer Systems for Better Care  in 2012, with a subsequent commitment by the Obama administration to establish the roadmap to develop the Centre, and it was further endorsed through the USA Food and Drug Administration Safety and Innovation Act (FDASIA) of 2015 . 

While the Centre has not been implemented as it was originally envisioned, many of its proposed members are active in the ‘Partnership for Health IT Safety’, a multi-stakeholder collaborative of more than fifty organisations that come together to analyse safety events and hazards, identify, and share solutions and safe practices, and inform policymakers and the broader healthcare community about priorities for health IT safety .

  1. Australia should assemble a taskforce of experts from across the health sector, to include clinicians, consumers, government, researchers, policy makers and industry to develop the vision, mission, outcomes and roadmap for better coordinated digital health patient safety in Australia. The taskforce’s expressed purpose is to ensure digital health is safer for patients and will build upon the significant progress already made in Australia, and internationally. 

  2. The taskforce’s objectives should include:

    a. Assembly: provide an opportunity for experts across the digital health spectrum to work together in a trusted environment, unconstrained by the competing interests of individual stakeholders.

    b. Cooperation: provide an opportunity for experts to share existing knowledge, evidence and resources and collectively contribute to actions and outcomes; and

    c. Collaboration: provide an opportunity for experts to work together to detect, report, remediate and disseminate information and solutions.

  3. The work of the taskforce should not replace existing patient safety activities, such as those that exist within the States & Territories, or within hospitals and health services; rather, focus on how digital health safety governance could be better coordinated across the nation.  

  4. The taskforce should examine the depth and breadth of policy, funding and regulatory levers that apply to all hospitals, primary care and health services, to identify gaps and determine solutions. This would include an environmental scan on what currently exists to better inform the solutions.

  5. The taskforce should examine the requirements for national reporting of digital health-related patient safety events, to include an agreed set of metrics, along with the supporting infrastructure required to build it. 

  6. The taskforce should be ‘housed’ within an existing national organisation, such as the Commission or the Agency, to expedite the establishment of its operations. Importantly however, it should function independently of the host organisation, and at arm’s length of government or industry to avoid conflicting interests. 

  7. The taskforce could integrate with the Australian Alliance for Artificial Intelligence in Healthcare  (AAAiH), led by Professor Coiera, given that one of the key components of the AAAiH is the establishment of the ‘Safety, Quality and Ethics Program’, which will contemplate the development of appropriate frameworks for safety and ethical governance and regulation of healthcare AI. 

Keywords: Digital health, standards and guidelines, accountability, patient safety, clinical risk management, Electronic Health Record

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