Few users are more mobile, and juggle more information than clinicians. On average a clinician sees one patient every seven to nine minutes, with about two minutes travel between patients and for every ten patients he sees, anywhere from one to five questions arise which require further information (British Medical Journal, August 1999). Clinicians’ 24/7 access to information is absolutely essential to the quality of care they provide.
In 2000, a report stunned the medical community. It showed that medical errors are one of the nation’s (US) leading causes of death and injury. The report, To Err is Human: Building a Safer Health System, estimated that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of medical errors. This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS.
To compound this fact, errors in health care have been estimated to cost more than $5 million per year in a large teaching hospital, and preventable healthcare-related errors cost the economy from $17 to $29 billion each year (Translating Research into Practice. Reducing Errors in Health Care). An editorial in the BMJ extrapolates from a pilot UK study which showed that in England and Wales adverse events lead to an extra three million bed days at a minimum cost of £1bn per year (BMJ 2001)). The good news is that many medical errors are preventable. For example, research suggests that over half of all adverse drug reactions are preventable through alerting systems, controls on administration and ordering.
The message is clear. Providing the necessary information, when and where it is needed, can save lifes and cut costs.
Two tools needed to master information:
- A method of being alerted to new information (foraging)
- A tool for finding the information again when you need it. (hunting)
Clinicians are flocking to PDAs and they are pulling their institutions with them – forcing them to keep pace and support mobile technology. PDAs, along with properly structured content, can positively affect how clinicians care for their patients.
Physicians say PDA use at the point of care cuts medical errors and provides vital decision support. Nevertheless, just one in five can link their PDAs to the larger hospital IT enterprise, according to research by Skyscape.
High quality, integrated clinical information is at the crossroad of clinical research, evidence-based health care and the clinical application research.
Consequently, a coherent clinical information framework is required. The inability to deal effectively at the point-of-care with clinical information is a key limitation to using informatics to support safe, evidence-based healthcare and to gather the information needed to deliver clinical governance.
We are trying to address some of these challenges by launching a project (Mobilmed) to develop a software solution for mobile devices connecting to hospital information systems and decision supporting tools.
It would be interesting to see where the Centrope region is at the moment, and how much resources are dedicated to issue these problems.
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