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Barcamp health it berlin2014 tobias neisecke-final

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Barcamp health it berlin2014 tobias neisecke-final

  1. 1. „Journal club“: Vorstellung des Perspective Paper The dangerous decade Barcamp Health IT 2.0 03.April 2014, Berlin
  2. 2. About me Tobias Neisecke Approbierter Arzt & Examinierter Krankenpfleger Wissenschaftl. Mitarbeiter Uni-Klinik Entrepreneur im 3D Umfeld Blogger – medizin-und-neue-medien.de Co-Organizer Health 2.0 Berlin
  3. 3. www.health20berlin.com Twitter: @health20berlin
  4. 4. (Über-)Leben im gefährlichen Jahrzehnt: The dangerous decade
  5. 5. Fakten Titel: The dangerous decade Autoren: Enrico Coiera, Jos Aarts, Casimir Kulikowski Published: 24. November 2011 online Journal of the American Medical informatics Association (JAMIA) J Am Med Inform Assoc 2012;19:2-5 doi:10.1136/amiajnl-2011-000674
  6. 6. Der Autor Enrico Coiera Professor @ University of New South Wales, AUS Director @ Center for Health Informatics Australian Institute for Health Innovation Twitter:@ EnricoCoiera
  7. 7. Kernthesen Over the next 10 years, more information and communication technology (ICT) will be deployed in the health system than in its entire previous history.
  8. 8. Kernthesen Systems will be larger in scope, more complex, and move from regional to national and supranational scale.
  9. 9. The paradox between ICT and patient safety ICT can improve the quality, safety and effectiveness of clinical services and patient outcomes.
  10. 10. Beispiel: Handschriftliches Rezept vs. Elektronische Verordung ->Eindeutige Verordnung
  11. 11. paradox between ICT and patient safety ->Rapid deployment of ICT is a priority for many nations faced with a diminishing clinical workforce, increasing workloads, and resource constraints.
  12. 12. paradox between ICT and patient safety ICT use can also lead to patient harm. ICT has yet to deliver on its promises. The rapid adoption of ICT is a risk.
  13. 13. Beispiel: Problem: „Verutschen“ im Dropdown-Menue (aus mg wurde g = 1.000-fache Dosis) Eskalation 1: Bestätigungs-Popup Problem: „Popups nerven“ Eskalation 2: Abgleich mit pharmakologischen Datenbanken und Fehlermeldung bei „Falschdosierung“ Problem: Off Label Use (zum Beispiel Intensiv, Kinder) Eskalation3: Personalisierte Alarmshemata Problem:... usw.
  14. 14. „Eskalationskaskade“ ● Eskalationsschritte nicht einheitlich (Fehlende Standards) ● Können auch ganz fehlen (z.B. Mobile Apps)
  15. 15. Kernthesen Even if ICT harm rates do not increase, increased ICT use will increase the absolute number of ICT related harms.
  16. 16. Non-linearer Anstieg? ● number of new implementations ● number of new users ● growth in rate of usage contribute to increased harm, suggesting more of a logistic curve
  17. 17. 19.02.14 ICT-associated patient harm is likely to increase in step with ICT usage. Coiera E et al. J Am Med Inform Assoc 2012;19:2-5 Copyright © by the American Medical Informatics Association. All rights reserved.
  18. 18. Kernthesen Yet we are at roughly the same place the aviation industry was in the 1950s with respect to system safety.
  19. 19. Kernthesen Will health ICT have to go through a similar painful period of learning from unexpected accidents?
  20. 20. Fiktive Schlagzeilen Patient starb durch Mobile App Spiegleinonline, 1.April 20XX Killer-App hat zugeschlagen Blöd online, 1April 20XX
  21. 21. 19.02.14 Changes in configuration will alter the opportunities for harm within a system, some making it safer and others less so. Coiera E et al. J Am Med Inform Assoc 2012;19:2-5 Copyright © by the American Medical Informatics Association. All rights reserved.
  22. 22. Soziotechnischer Kontext Our understanding of the unintended opportunities for harm that arise when interruptions and multitasking disrupt clinicians using information systems is also in its infancy. The psychological literature on interruption is complex, and designing ICT that is ‘interruption safe’ remains a challenging goal.
  23. 23. Fazit Flugzeuge werden immer vom Himmel fallen. 100%-ige Sicherheit wird es nie geben.
  24. 24. Fazit Entwicklung von sicherer ausgereifter Health IT bedeutet enormen Aufwand, aber ● sichert (langfristigen) wirtschaftlichen Erfolg ● Zeigt Verantwortung ● Führt zu Akzeptanz beim Nutzer und der Öffentlichkeit
  25. 25. Vielen Dank! Mit den besten Wünschen für das Jahrzent! Tobias Neisecke tobias@health20berlin.com Twitter @tobias_neisecke www.medizin-und-neue-medien.de Barcamp Health IT 2.0 03.April 2014, Berlin

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