The role of technology in delivering quality patient care

In a recent whitepaper, JCI looks at the role of digital clinical information tools in delivering current, trusted knowledge to promote quality care and patient safety

The quest for quality is always an ongoing endeavour in healthcare.

Quality here would generally be defined by ideal or desired health outcomes for patients, and can be said to be the ultimate goal for healthcare organisations and professionals.

However, healthcare today faces several key challenges in achieving this. For one, patient volume is rising in many countries, driven by ageing populations. Clinicians also have to grapple with the rapid pace of change in medicine, and any new threats or infections that emerge (with COVID-19 and its multiple variants being a clear example).

Evidence-based knowledge, and access to this knowledge, will be key to overcoming these challenges, says The Joint Commission International (JCI), in a recent whitepaper delving into quality of care.

In the paper, JCI noted that the difficulties that clinicians face in achieving evidence-based decision-making in today’s landscape.

“When reviewing medical information, the user needs to determine whether there is enough scientific evidence to demonstrate effectiveness; whether the findings from the research apply to different patient populations in a real-world setting; and how feasible it is to implement the recommended care. The biggest challenge is culling through the enormous volume of medical information,” said the authors.

This challenge has been made apparent during the COVID-19 pandemic. More than 23,000 COVID-19 papers were published in the first five months of 2020, and doubling every 20 to 30 days. Misinformation and disinformation arose, adding to confusion on the ground. The lack of properly curated and distributed evidence-based information led to wide variation in care delivery, and thus variation in quality of outcomes.

Role of technology to promote quality

Against this backdrop, JCI highlighted the role that technology can play to facilitate access to evidence-based information, thus improving quality and safety.

“Technology can support quality through improved communication, improved access to information and data, reduced variation, remote monitoring, clinical decision support, and advanced data analysis.”

 “It is rapidly replacing the library and hard-copy journals. Digital tools facilitate access to curated content that is analysed and summarized with recommendations, using methodology without bias. The challenge of accessing evidence-based practices can be addressed through digital resources,” they noted.

Search engines or medical databases on the internet – such as Google, PubMed or Cochrane’s Review – have become widely used digital resources. By simply keying in search terms, clinicians are able to quickly access relevant information anytime, anywhere.

However, the quality of information obtained through these sites may vary, JCI cautioned, as these search engines do not filter based on quality parameters. Information may be incorrect, incomplete, or outdated. Furthermore, for more complex clinical questions, these databases won’t be able to provide the necessary analysis or clear direction of the steps to be taken.

Recommendation for clinical information solutions

Technology in the form of clinical information tools would offer a more reliable source of high-quality information for care providers instead.

These tools consolidate updated, curated medical information from many sources, to guide point-of-care decisions. They can also be integrated within Electronic Health Records to build upon patient data within.

This can greatly enhance patient safety, said JCI, as they can provide real-time information on drug-drug interactions, therapeutic duplications, drug-allergy conflicts, and medication-dosing checks, based on patient-specific data. Algorithms can work with individualised patient factors to recommend best therapy options and clinical decisions.

The strength of this technology lies in its ability to give health care providers “specific, actionable, evidence- based information at the point of care,” thus promoting more effective and efficient care delivery.

The authors summarised the capabilities of point-of-care technology as follows:

  • Synthesise current evidence for diagnosis, tests, and interventions (for example, treatments, drugs), with recommendations
  • Are designed for rapid consultation at the point of patient care
  • Are evidence-based and frequently updated, with links to relevant literature
  • Can provide prompts for disease state screening and disease diagnosis, indicators of changing patient conditions, and predictors of survival for patients who are critically ill
  • May include drug information, or hospital formulary medication preferences
  • Supports medication prescribing, preparation and administration, and identifying and managing adverse drug events
  • May include information for patients
  • May be integrated in electronic health records and use patient-specific data to provide feedback

Wolters Kluwer, for example, compiled more than 100 independent clinical studies with findings that demonstrated improvements in many core quality measures across conditions, from shorter hospital stays to fewer unnecessary tests.

The below table demonstrates how point-of-care clinical information products can support the delivery of quality care as defined by the six dimensions of quality.

Dimension of Quality  Point-of-Care Product and Function
Effective
Goal: Diagnose and select treatment plan that is evidence-based.  
Point-of-care clinical information tool
■ Differential diagnosis
■ Recommended lab tests
■ Access to clinical practice guidelines for ovarian cancer  
Efficient
Goal: Select medication that is available.  
Point-of-care formulary management system
■ Chemotherapy agents are available at the hospital for no additional costs  
Person-centered
Goal: Provide information pertinent to patient concerns.  
Point-of-care clinical information tool
■ Patient education materials pertinent to the diagnosis and patient concerns  
Safe
Goal: Avoid adverse medication events.  
Point-of-care clinical information tool
■ Medication selection
■ Drug-drug interaction  
Safe
Goal: Manage adverse events.  
Point-of-care clinical information tool
■ Management guidelines  
Timely
Goal: Remove barriers to accessing care.  
Point-of-care clinical information tool
■ Alternative medications  

Choosing the right clinical information products for your hospital

With a range of clinical information products available in the market today, JCI advises hospitals to closely evaluate the features of each product, and take in end-user inputs (their roles and usage requirements, type of information sought, and so on) to ensure the investment brings the most value. The tools will need to meet the needs of three different groups of stakeholders:

1. Clinicians

Clinicians will be primarily concerned about 1) the quality of the content (whether it’s evidence-based, non-biased, updated, and so on); 2) the scope of information and breadth of topics covered; and 3) the ease of use.

In addition, it’s important to note that each discipline – physician, nurses, pharmacists, and so on — will have different needs from a point-of-care tool. For example, physicians will likely use it to assist in diagnosis and treatment recommendations, whereas nurses will look for more information on medication administration, side effects and monitoring needs.

It is thus important to define the intended audience and their needs, and choose one that best meets them.

2. Patients

Patients can benefit from comprehensive information about their disease state, including treatment procedures or drugs. The value of point-of-care tools is enhanced when these information are customised for the patient – in their preferred language, at their health literacy or education level, and accompanied with visuals.

3. Organisations

Point-of-care products can help promote standardised evidence-based practices throughout the organisation. They act as content curators, synthesising a large volume of evidence-based information which can then be incorporated into institution-wide protocols – reducing care variation and optimising care for all patients.

A point-of-care digital tools that can meet the above needs will empower clinicians and organisations to deliver evidence-based, quality care despite the tough environment they operate in today. While adoption of these tools require thoughtful planning and training and maintenance, this will be a crucial step towards the ultimate goal of delivering quality healthcare to all patients.

Click here to download the full whitepaper by JCI, “Using Point-of-Care Clinical Information Products to Promote Quality Patient Care”

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