What’s in a headline?

Following press coverage claiming computers are responsible for hundreds of deaths a year, the Chief Information Officer for Health and Care takes a moment to reflect on the research, and the evidence that IT improves the quality and safety of the care we provide to patients:

Press reports published last week claimed two academics had asserted that more than 900 deaths a year in the NHS could be attributed to poor technology.

Having had time to reflect on the paper, I thought I should respond, both to the ‘evidence’ and arguments made in the paper itself, as well as to provide evidence from the frontline about the positive impact of technology on care and outcomes.

Whilst the headline described hundreds of deaths due to computer defects in the NHS in England, the paper itself states that while “there are suggestive case studies, there has been virtually no systematic research to study any causal relation”.

No direct evidence is provided for the assertion that hundreds are dying, but rather US data on preventable adverse events (PAEs) has been extrapolated to the UK, and then the authors make the assumption that 1% of all preventable adverse events involve computer system defects and inefficiencies and that computer-related PAEs are as likely to cause serious injuries or deaths as other PAEs.

The NHS looks after more than a million patients every day.

We deal with life and death and every one of our staff regularly goes above and beyond the call of duty to provide the best possible care they can for their patients.

Our staff use a number of clinical systems, computer systems and world leading medical technologies.  The NHS takes the safety of Health IT Systems very seriously, and the standards underpinning clinical safety design for the manufacture or deployment and use of Health IT systems are enshrined in UK legislation.

The evidence of digitisation is that it reduced drug errors, improves continuity of care and saves lives.  A new study, published this week in the Journal of Medical Internet Research, analysing literature from the last five years, found a positive link between the adoption of health information technology and clinical outcomes, both in terms of efficiency and effectiveness.

This mirrors early findings from the Global Digital Exemplar (GDE) programme, where we are seeing real evidence of the positive impact of health IT including the:

  • Deployment of electronic Venous Thromboembolism (VTE) at Salford which has led to a significant reduction in the rate of VTE;
  • Reduction in re-admissions for Type 1 diabetes patients with Diabetes Ketoacidosis (DKA) at City Hospitals Sunderland;
  • Cardiac arrests have reduced by 46% at Royal Liverpool with the use of digital tools to identify deteriorating patients quickly and dealing with their clinical care effectively.

This is a small sample of the work that is happening on the ground, and the real-world results of safely applying technology to support care.

Scaremongering for the sake of promoting a lecture does more harm than good.  I would like to work with the academic community to help us deploy technology more effectively to improve the quality of care that we provide.

Cheap headlines that frighten the public, demoralise staff and impede progress, do not help.

Will Smart

Will Smart is Chief Information Officer (CIO) Health and Care in England.

A joint appointment between NHS England and NHS Improvement, Will is responsible for providing strategic leadership across the whole of the NHS to ensure that the opportunities that digital technologies offer are fully exploited to improve the experience of patients and carers in their interactions with health and social care; the outcomes for patients; and improved efficiencies in how care is delivered.

Prior to taking up this role, Will was Chief Information Officer at the Royal Free London NHS Foundation Trust for six years and. He first worked in the NHS in Wales and Northern Ireland during his placement year from university, before taking up an analytics role at St. Mary’s NHS Trust in London on graduation.

In addition to senior roles in the NHS, Will has worked as a management consultant with major assignments focussing on IT strategy, service transformation, major IT service and contract reviews and outsourcing.

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  1. Martin Greenfield says:

    I think the NHS should rely on paper to record data for another few years yet and run it along side the computer systems to keep check.
    Paper is difficult to store grant it,but is cheaper needs no technology,environmentally friendly,and has a personal touch.

  2. Ben Goldacre says:

    The research and examples referred to here sound interesting, but none of them are linked? The JMIR paper I think I can identify from the description, but it’s not clear (was the link left out by mistake?). The GDE examples don’t seem to be available to read anywhere? Could we have links please?

  3. Dr.Shivam Natarajan says:

    Having worked with Will before I fully understand his frustration and angst on such headlines. As a firm believer in healthcare IT I fully agree to his response,but such headlines will continue.
    While we invest billions in deploying IT in healthcare we have not invested adequate time, money or effort in quantifying it’s benefits with sound evidence.
    It is time the NHS sponsored some of the Early adopter sites to conduct rigorous studies both prospective and retrospective to establish the value of IT in healthcare. In the days of Value based medicine where we challenge the cost benefit of every clinical decision, it is only natural for people to raise such headlines.

  4. Jim massey says:

    A voice of sanity at last! Health care around the world has dramatically improved with the introduction of EMR. This base of data will fuel life changing improvements in care and wellness as we analyse the data we have captured. Luddites who wish for non computer assisted health are going away as a new generation of computer savvy professionals fill the spaces.

  5. Paul Russell-Roberts says:

    Very well written and very good points. Really nice to see positivity in respect of the integration and usage of digital technology in the HNS. Thank you