Introduction
As I talked about in my last blog post, health systems are complex things. At their full potential, all components of the system (e.g. your healthcare providers, such as a hospital, or a GP surgery) should be fully interoperable. This promotes a more streamline patient experience as well as bolstering resilience for disaster response.
Over the past decade, there has been a marked increase in digital technologies within healthcare, revolutionising how care is provided and managed.
Electronic Patient Records have replaced traditional paper records, offering a more efficient and accurate way to store and retrieve patient information. EPRs streamline workflows, reduce errors, and provide healthcare providers with instant access to comprehensive patient histories, which enhances the quality of care and decision-making.
Telemedicine has transformed the way patients interact with healthcare providers. It enables remote consultations, making healthcare accessible to people in rural or underserved areas, and allows patients to receive medical advice without leaving their homes. This technology has been especially crucial during times of crisis, such as the COVID-19 pandemic, when minimising physical contact was essential.
Advancements in digital diagnostics and wearable technology have empowered patients to take a more active role in managing their health. Wearable devices like smartwatches and fitness trackers monitor vital signs, activity levels, and other health metrics in real-time. In England, acute care at home is a successful example of where this innovation as enabled new models of care delivery.
Utilising such technology provides marked benefits for healthcare providers and patients. For providers, it means improved efficiency, better resource management, and enhanced ability to deliver timely and accurate care. For patients, it translates to greater convenience, more personalised healthcare experiences, and hopefully better health outcomes.
In addition to clinical applications, the vast majority of administrative activities within healthcare take place digitally.
When downtime strikes
Digital downtime can occur due to various reasons, including cyberattacks, system failures, software glitches, or power outages.
Cyberattacks pose a significant threat to healthcare organisations, causing downtime by disrupting network operations or compromising sensitive patient data. In particular, healthcare providers appear a popular target for ransomware.
Software glitches are another common cause of digital downtime in healthcare. Bugs or errors in software applications can result in system crashes or data inaccuracies, necessitating downtime for troubleshooting and resolution. As I am typing this, the world is experiencing what is quite likely the worst global IT outage ever experienced, and mass disruption has set in from healthcare to transportation. In England, we have seen some providers declaring 'Critical Incidents' - this indicates that they have had a loss of service impacting the delivery of critical services.
Additionally, power outages, whether planned or unexpected, can disrupt the functioning of electronic devices and systems, leading to downtime until power is restored. I have experienced this as a growing risk over my time in health system resilience.
Digital resilience
A fundamental question within the healthcare resilience domain therefore revolves around strategies aimed at mitigating the impact of digital downtime.
One of the primary focuses should be on establishing a comprehensive IT infrastructure that is not only robust but also equipped with backup systems to guarantee the continuity of operations, even when faced with technical failures. Regular maintenance and updates play a pivotal role in ensuring the smooth and efficient functioning of systems, thereby reducing the risk of disruptions.
Business continuity is key.
A further critical aspect is the implementation of stringent cybersecurity measures to safeguard sensitive data and prevent any potential breaches that could compromise the integrity of the health systems. By prioritising cybersecurity, organisations can fortify their defenses against cyber threats and uphold the confidentiality of patient information. In the English NHS, strigent data protection security standards are mandated and assured through NHS England (having absorbed NHS Digital).
One final key point that emerges is the significance of staff training and preparedness in dealing with digital downtime scenarios. Equipping healthcare professionals with the necessary skills and knowledge to navigate such situations is imperative for upholding the quality of patient care and minimising service interruptions.
Staff who join our organsiations post digitisation may have never used the previous hand-written forms. In ambulance services, for example, are we ensuring student paramedics are trained on how to complete physical form versions of patient records, as well as EPRs?
A digital and resilient future
The flip side of this gorwing digital dependance (and possibly growing vulnerability), is the integration of emerging technologies that hold the promise of bolstering the capacity of healthcare systems to withstand and respond to challenges.
Among these transformative technologies, Artificial Intelligence (AI) and machine learning stand out as game-changers by revolutionising diagnostics, treatment plans, and predictive analytics. There is also great untapped potential for AI to be harnessed across the field of health emergency management.
However, the successful integration of these technologies into health systems necessitates a supportive policy and regulatory framework. Policies that promote interoperability, data privacy, and ethical use of AI are essential to ensure the responsible adoption of these technologies while safeguarding patient rights and confidentiality. Regulatory bodies play a crucial role in establishing standards, guidelines, and oversight mechanisms to govern the implementation of emerging technologies in healthcare, thereby fostering a resilient and patient-centered healthcare ecosystem.
Striking the balance
We can no longer strike the balance between preparedness and technology, without first recognising the intricate relationship between the two. Technology undoubtedly plays a crucial role in enhancing preparedness efforts, offering innovative solutions for risk assessment, communication, and response coordination. However, it is equally important to recognise the limitations of technology and the need for human skills, experience, and intuition in preparedness planning.
We cannot allow human skills to be degraded as a result of reliance upon digital solutions, but nor should we shy away from the transformational potential of those digital solutions.
Human factors such as leadership, decision-making, and effective communication remain fundamental to successful emergency response. While technology can provide valuable data and insights, it is human judgment and expertise that ultimately drive effective decision-making in crisis situations.
Striking a balance between technology and preparedness requires a holistic approach that leverages the benefits of technology while recognising the importance of human skills and inclusivity.
Closing thoughts
The future is exciting with respect to digital advances. They will continue to enhance both patient care, and health system resilience. I, like many, will watch with interest as the rest of todays events unfold. Many emergency managers will be busy beaving away on response, and I hope we see a resolution as swiftly as possible.
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