Health IT Risks - Background

Risk management is at the heart of many practices within medicine and healthcare. It is clearly in every patients' interest for clinicians to hold the principles of the Hippocratic Oath so close to their hearts. With the emergence of more and more specialist disciplines and the continual drive for improvements, care is increasingly being delivered by multidisciplinary teams. However, multidisciplinary team working introduces huge challenges for communication and sharing of information.

Information Technology(IT) offers tremendous opportunities for joining up disparate business processes. There is also a perception that the introduction of computer systems will inevitably improve safety in many areas of clinical practice. Information technology certainly has huge potential to improve the consistency of the healthcare experience and the quality of clinical record keeping. However, we need to be careful because the interactions within healthcare are complex and there are numerous ways in which the clinical business processes can fail in ways that could cause harm to patients.

For many the most obvious pitfalls are those relating to Information Governance and privacy in particular. The Health Insurance Portability and Accountability Act (HIPPA) in the US and Data Protection Act(DPA) legislation in Europe has established statutory requirements that need to be met to address these risks. However, this legislation and associated standards do not properly address the risks of harm to patients arising from anomalous behaviour within information system.

Examples of anomalous behaviour that could lead to harm include:

• Incorrect output from clinical decision support functionality
• Failure to record details of an allergy correctly
• Failure to reliably transfer or refer the care of a patient to another provider

Since these scenarios have the potential to increase the risk of harm to patients they are described as Clinical Hazards. The practice of identifying, risk assessing and mitigating Clinical Hazards is termed Clinical Risk Management.