Characterizing patient details-related challenges from health information technology-related incident reports from Swedish healthcare

Abstract

IntroductionDespite many benefits offered by Health Information Technology (HIT) systems, new technology brings new and unforeseen risks to healthcare quality and patient safety if they're not properly planned, designed, implemented, and managed. This study examined health information technology-related (HIT) incidents to identify patient details-related issues, their association with contributing factors, and outcomes.MethodsSources of information comprised retrospectively collected incident reports (n = 95) using two sampling methods, i.e., purposive and snowball sampling. The incident reports were analyzed using both the inductive method (thematic analysis) and the deductive approach using an existing framework, i.e., the International Classification for Patient Safety.ResultsThe studies identified 90 incidents with 120 patient details-related issues—categorized as either information-related (48%) or documentation-related (52%) problems; around two-thirds of the 120 issues were characterized by human factors. Of the total sample, 87 contributing factors were identified, of which “medical device/system” (45%) and “documentation” (20%) were the most common contributing factors. Of 90 incidents, more than half (59%) comprised patient-related outcomes—patient inconvenience (47%) and patient harm (12%) and the remaining 41% (n = 37) included staff or organization-related outcomes.DiscussionMore than half of the incidents resulted in patient-related outcomes, namely patient inconvenience and patient harm, including disease risks, severe health deterioration, injury, and even patient death. Incidents associated with patient details can cause deleterious effects; therefore, characterizing them should be a routine part of clinical practice to improve the constantly changing healthcare system.

Operational disruption in healthcare associated with software functionality issue due to software security patching: a case report

“…Notwithstanding these limitations, the findings and the devised strategies can be considered as alerts to enlighten healthcare digitalization in Sweden to adopt the culture of digital safety and effectiveness. This also implies that the lessons learned from this case report can be useful and pertinent to adopt elsewhere for overall healthcare quality improvement and patient safety (7,17,32).…”

“…Such disruptions in the workflow process cause significant delays in patient treatments, patient inconvenience, and risks to patient safety, including repeat images resulting in unnecessary radiation and even additional workload for radiographers, i.e., repeat reconstruction of radiographic images. A recent study indicated that approximately 41% of the total sample of incidents had a staff/organization-related outcome with a clear indication that workflow disruptions resulted in additional system/service/resource use and delays in using facilities/service/systems ( 7 ). These delays in treatment or procedure further cause delayed diagnosis, treatment initiation, impact, and monitoring.…”

“…HIT systems were deployed with the vision of making care delivery safer and more efficient by reducing adverse events and improving accuracy ( 7 ). The HITs have improved several dimensions of healthcare quality, such as enhancing the security and confidentiality of personal health information ( 8 ), improving patient safety, and increasing efficiency and effectiveness ( 9 ).…”