Keeping patients safe is intrinsic to the work of healthcare professionals. It is at the core of all we strive to achieve, but unfortunately, modern medicine still sometimes falls short. There are identified gaps in the way patient information is recorded, with fragmented and “siloed” information. But thankfully, as technology plays an ever-increasing role in healthcare, it is helping to keep our patients safe.
As a doctor and a human being, I don’t know what I don’t know! There are inevitably pieces of information that are missing – from my Electronic Medical Records (EMR) system and from my patient’s memory. But as data-driven patient safety emerges, we have access to better tools, to achieve better patient outcomes. As demonstrated globally, Health Information Exchange (HIE) platforms allow healthcare professionals to safely and securely share a patient’s most important medical information, digitally. The technology allows us, as care providers, to securely share information in a way that was not possible before. The introduction of Malaffi is a strategic effort by the Department of Health Abu Dhabi towards a digital transformation of the healthcare ecosystem and is helping to further improve the quality of healthcare services and ensure patients’ safety. Knowledge really is power and by filling in inconsistencies in information, I can make better-informed decisions, which ultimately puts safety first.
Material and psychological benefits to safety
Within a clinical setting, HIEs offer both material and psychological advantages to safety, for both the healthcare professionals and the patient. Materially, HIEs provide access to a structured presentation of data including current and significant past medical conditions. I have the data on my EMR, but what an HIE provides is what is missing from this picture – filling critical knowledge gaps to aid clinical decision-making.
If we look at the psychological advantages, HIEs empower both the patient and the provider. Patients can be confident that the most informed decisions are being made about their care, based on accurate information from their individual health journey and avoid preventable errors. I have had patients say to me ‘Dr, I’ve seen my endocrinologist, you must have the results. Tell me what’s next’. This is a fantastic attitude for patients to have. This type of transparency and patient engagement makes sure we both invest in their safety, right from the start. As a doctor, I often got a very fragmented view of a patient care summary. There are gaps and grey areas. But HIEs provide a credible, holistic view, in an organised format. They give a comprehensive picture of my patient’s history, even if they have been seen outside of my network. By filling the gaps, it gives us detailed information on critical information, and this helps ensure safety is at the forefront of all my clinical practice.
Critical pieces of information
It is thought that up to 18% of patient safety errors and as many as 70% of adverse drug reactions could be eliminated if the right information, about the right patient, was made available. With the use of HIEs, this is possible. Critical pieces of missing information include details of any known allergies and current prescriptions, meaning that we can prevent potentially dangerous drug interactions or allergic reactions, and duplicate prescribing can be avoided. I can then add a note to a patient file to make sure any medications that are likely to cause adverse reactions aren’t included in any future prescriptions. Since I began using Malaffi in 2019, I have witnessed many instances where potential harm to the patient has been avoided because of the information that I have access to. For example, I saw a patient recently who was taking thyroxine for his condition. He didn’t realise, but he was actually taking a double dose. He had been prescribed the same medication twice, by different doctors, with two different brand names. Malaffi helped me spot and correct that error, saving the patient from potential significant side effects.
Invasive tests and harmful exposure
HIEs prevent unnecessary and repetitive diagnostic tests by presenting relevant recent results to all clinicians involved in patient care, hence reducing the exposure to radiation (scans etc) and other invasive procedures.
A better coordination of care
Arguably the ultimate benefit of an HIE is in the coordination of care, offering a better healthcare experience and improving outcomes. For example, if a patient is admitted to hospital to receive treatment for an acute condition, and he returns to me, as his family physician for follow up, I can see what they were admitted for, what tests and investigations were carried out, what the diagnosis was, and any prescribed medications. Historically, medical records are often fractured, illegible, and as a clinician I felt a duty to check everything, to ensure my patient's safety. This often caused a critical delay in patient care, as waiting for information or results to be shared caused valuable time to be lost.
Malaffi’s role in Abu Dhabi’s COVID response
The absolute requirement for healthcare systems to have accurate, complete data on public health available to them, when and where it is needed, was never more apparent than during the recent pandemic. In countries like Singapore, where lessons had been learnt from the SARS experience almost twenty years ago, the use of their tech-driven health system helped shape the countries disaster preparedness. In the UAE, as an immediate response, Malaffi integrated all lab services in the Emirate providing access to real-time results which weren’t subject to manual delays. Access to medical history and information on any underlying health conditions enabled HCPs to triage patients quickly and effectively. Malaffi plays a critical tool in containing the virus and helps keep us all safe, particularly those most at-risk.
The future of patient safety
Looking at the bigger picture, I see huge opportunities for HIEs to improve patient safety further and to support health management of the community. Never before have we had access to credible, reliable, clinical data, on such a large scale. I would like to see the UAE develop chronic condition registers. By monitoring certain criteria for every patient that we see, we can not only improve outcomes but ensure that the DoH can focus their resources on areas that really need improvement. It allows a better picture of public health to be formed. With credible data, we can strategise accurately for the health and safety of our community.
References available on request
Dr Goyal will be speaking on ‘Improving patient safety by bridging the information gap – The case of health information exchange’ on Friday, 6 November at Patient Safety