An investigation published by BBC News has revealed that Electronic patient record (EPR) system failures have been linked to the death of three patients and more than 100 instances of serious harm at NHS hospitals trusts in England. In this short blog, Patient Safety Learning reflects of these issues and the importance of patient safety being at the heart of the development and implementation of EPRs.
EPR systems are a way of managing clinical information with the intention of making this information more easily accessible for use by healthcare professionals. In A plan for digital health and social care published in June 2022, the Department of Health and Social Care set a target that all NHS Trusts should have an EPR system by March 2025.[1] In November last year, NHS England announced it was on course to meet this target, stating that 90% of NHS trusts have now introduced these new systems.[2]
When implemented safely, EPRs can support and improve care and treatment by:
However, there are also a number of patient safety risks associated with their implementation and use, as highlighted in a blog by our Chief Digital Officer Clive Flashman in January.[3]
In their investigation, BBC News found from a Freedom of Information (FOI) request sent to all acute hospital trusts in England (of which 116 responded) that:[4]
Commenting the findings of this FOI request, our Chief Digital Officer Clive Flashman said:
“Poor implementations of EPR systems can lead to direct and indirect harm to patients. Often this is not associated with the IT system and goes unreported, so we have no data to show the true scale of the issue.
We need more transparency in reporting and sharing knowledge so we can avoid patient safety problems and harm. This is a priority issue that must be addressed by those leading EPR implementations.”
At Patient Safety Learning we believe that patient safety needs to be a core purpose of health and social care. Patient safety considerations need to be embedded through each stage of the process when organisations introduce EPRs:
Reflecting on this, our Chief Executive Helen Hughes said:
“We must invest in proper implementation so that the benefits of EPRs and health technology are realised and do not lead to avoidable and unintentional harm. Actively involving healthcare professionals is essential to ensure we are designing for safety in often very complex workflow processes, so we better understand and respond to risks and manage the mitigations.”
[1] Department of Health and Social Care. A plan for digital health and social care; 29 June 2022. https://www.gov.uk/government/publications/a-plan-for-digital-health-and-social-care/a-plan-for-digital-health-and-social-care
[2] NHS Digital, 90% of NHS trusts now have electronic patient records; 16 November 2023. https://digital.nhs.uk/news/2023/90-of-nhs-trusts-now-have-electronic-patient-records
[3] Clive Flashman, NHS England warns electronic patient records could pose ‘serious risks to patient safety’: what can we learn?, 10 January 2024. https://www.patientsafetylearning.org/blog/nhs-england-warns-electronic-patient-record-could-pose-serious-risks-to-patient-safety-what-can-we-learn
[4] BBC News, NHS computer issues linked to patient harm, 30 May 2024. https://www.bbc.co.uk/news/articles/c4nn0vl2e78o