Quality and Safety in eHealth: The Need to Build the Evidence Base (Preprint)

Abstract

UNSTRUCTURED Research in the area of health technology safety has demonstrated that technology may both improve patient safety and introduce new types of technology-induced errors. Thus, there is a need to publish safety science literature to develop an evidence-based research base, on which we can continually develop new, safe technologies and improve patient safety. The aim of this viewpoint is to argue for the need to advance evidence-based research in health informatics, so that new technologies can be designed, developed, and implemented for their safety prior to their use in health care. This viewpoint offers a historical perspective on the development of health informatics and safety literature in the area of health technology. I argue for the need to conduct safety studies of technologies used by health professionals and consumers to develop an evidence base in this area. Ongoing research is necessary to improve the quality and safety of health technologies. Over the past several decades, we have seen health informatics emerge as a discipline, with growing research in the field examining the design, development, and implementation of different health technologies and new challenges such as those associated with the quality and safety of technology use. Future research will need to focus on how we can continually extend safety science in this area. There is a need to integrate evidence-based research into the design, development, and implementation of health technologies to improve their safety and reduce technology-induced errors.

Health technology, quality and safety in a learning health system

“…Wrong medication dose may be given 10,11 Difficult to locate information Decisions are made in the absence of information may lead to errors in healthrelated decision-making 11 occur. 24 Health informatics researchers have demonstrated that the right health technology, when designed and implemented using evidence-based approaches from the health informatics literature, can significantly improve the quality and safety of a process or healthcare activities associated with its use.…”

“…2,3 Health technologies have also been involved in patient safety incidents. [4][5][6][7][8][9][10] Patient safety incidents involving technology have been documented in acute care, 6,8-10 clinic, 10 home care, 11 and community settings. 11 Human factors researchers from the discipline of health informatics have developed strategies that can be used to design, test, and evaluate health technologies and technology systems of care for their safety.…”

“…[4][5][6][7][8][9][10] Patient safety incidents involving technology have been documented in acute care, 6,8-10 clinic, 10 home care, 11 and community settings. 11 Human factors researchers from the discipline of health informatics have developed strategies that can be used to design, test, and evaluate health technologies and technology systems of care for their safety. 9,10 To create a learning health system, using health technology safety theories, 9,12 methods, 10,11 maturity models, 1 and monitoring systems, 13 these activities need to be formally included as part of organizational quality and safety activities.…”

“…11 Human factors researchers from the discipline of health informatics have developed strategies that can be used to design, test, and evaluate health technologies and technology systems of care for their safety. 9,10 To create a learning health system, using health technology safety theories, 9,12 methods, 10,11 maturity models, 1 and monitoring systems, 13 these activities need to be formally included as part of organizational quality and safety activities. Such integration is needed to address the gap between modern approaches to digital health safety and current organizational practices.…”