Appropriate patient treatment without ICT?
Risk assessments, emergency procedures and improvement work at 17 hospitals
Report by the Norwegian Board of Health Supervision 2/2021
During 2020, the Norwegian Board of Health Supervision conducted a survey of critical systems, risk assessments and emergency procedures linked to ICT systems at 17 Norwegian hospitals. The findings made in the survey indicate that the trusts have prepared many risk analyses concerning ICT changes. However, few overall risk assessments have been prepared concerning the loss of all ICT services.
Most risk analyses focus on technical aspects, but little on the consequences of ICT loss in clinical activity. The health trusts have no systematic overview of the ICT cases that have the greatest consequences for appropriate healthcare and patient safety. The delegation of responsibility between regional health authorities, health trusts and ICT service providers is also unclear as regards the prioritisation of such matters.
The risk of failure in the health services increases the longer the loss of ICT continues. Hospitals rapidly lose track of admitted patients. In accident and emergency departments, many patients have unresolved conditions, and the risk of incorrect treatment increases when the patient's medical history is unknown. The health trusts lack adequate emergency solutions for access to information concerning new patients when the normal patient record system is unavailable. Most health trusts believe there will be a significant risk of failure in health services once the electronic patient record system has been inaccessible for two hours.
The health trusts are working systematically to develop emergency procedures and ensure that healthcare professionals are drilled in their use. However, the trusts have inadequate emergency procedures and/or practice regimes for some technical communication solutions such as alarms and telephone systems. This is critical because the solutions are increasingly being based on ICT networks, yet they are pivotal to many emergency procedures at hospitals.
The survey also revealed a lack of consistency in important data concerning the patient's use of medication. Despite known challenges relating to drug information and the vision of "One Citizen - One Health Record", many health trusts have introduced new systems with duplicate data, requiring additional log-ins and patient lookups for healthcare professionals.