World Patient Safety Day: Preventing harm in healthcare in a digitalised world

According to WHO data, 1 in 10 patients experience harm in healthcare, and more than half of this harm is preventable. Perhaps innovations in digital health, from telemedicine to AI-enabled medical devices, could help: they have the potential to considerably improve the resilience of health services, enhance patient safety, and elevate the overall quality of care.

Patient safety refers to the “first, do no harm” principle, which is the most fundamental principle in medicine; it is about preventing errors and unnecessary harm affecting patient’s health. Investing in patient safety is not solely beneficial for patients but also for the economy, as patient harm negatively affects the global economy, reducing its growth by 0.7% a year.

In 2019, the World Health Organization (WHO) adopted a resolution on “Global action on patient safety” to recognise patient safety as a critical global health priority. As part of this resolution, WHO established World Patient Safety Day to be celebrated annually on 17 September. This day calls for international and joint efforts by all countries to improve patient safety with a different theme each year.

In 2024, the focus is on “improving diagnosis for patient safety“, underlying how correct and timely diagnosis can genuinely make a difference in ensuring better health outcomes for patients.

Diagnostic errors can involve incorrect, delayed, or missed diagnoses, as well as a failure to communicate effectively with the patient. These errors contribute to 16% of preventable patient harm worldwide and are often due to issues in patient-practitioner encounters, such as history taking, examination, and test interpretation. 23% of EU citizens claim to be affected by a medical error, with 18% experiencing a severe error in a hospital and 11% stating to have received the wrong medication.

Dr João Breda, Head of the WHO Athens Quality of Care and Patient Safety Office & Special Adviser for the Regional Director: “We need to use all the tools we can to ensure that we reduce unnecessary harm to the minimum. Digital solutions like telemedicine can potentially improve patient safety globally and reduce negative effects linked with inaccurate and improper diagnoses. However, just because it’s telehealth doesn’t mean it will be good. We have both risks and opportunities when applying digital solutions, and we must first evaluate their quality.” – Read the full interview with João Breda

Telemedicine and other digital-based health services can help to establish safer diagnostic processes, overcoming possible geographical and communication barriers. They have seen an exponential increase during the COVID-19 pandemic and its aftermath. Almost 60% of the states in the WHO European Region made new laws or policies to support telehealth when the pandemic occurred. Currently, about 77% of them use telemedicine or remote patient monitoring. Additionally, earlier this year, the WHO Office on Quality of Care and Patient Safety launched the “Telehealth Quality of Care tool (‎TQoCT)” that aims to serve as a guidance and self-assessment instrument for telehealth services quality improvement and is helpful at all levels.

Eric Sutherland, Senior Health Economist leading the OECD’s work in Digital Health: “Using technology also involves some risks that are important to be aware of. Machines may come up with a recommendation that does not make sense. That is why having a doctor, a health professional, in the loop to interpret the insights from the system is fundamental. It is also necessary to consider how messages are delivered, especially when they are negative diagnoses.” – Read the full interview with Eric Sutherland

Eric Sutherland also draws the attention to the risks related to cybersecurity: “When it comes to security, it’s crucial to consider it in the design of health systems. The complexity and scale of the infrastructure should take into account that security risks are always present, with hackers continuously attempting to breach systems. Designing security into our systems and having protocols in place for potential breaches is essential…Additionally, providing training for staff to recognise and prevent cyber-attacks is a highly impactful measure”

Engaging patients in their health journey

The Global Patient Safety Action Plan stresses the importance of actively involving patients and their families. They offer unique insights derived from personal experiences that others cannot provide. By acting as the system’s eyes and ears, they play a crucial role in advancing safer healthcare. Technology can definitely play a role in this sense.

From providing information through apps, sending real-time messaging and alerts facilitating communication with health professionals, to tools to collect patient experiences when exposed to unsafe care, there are endless possibilities for further engaging with patients and their families to develop more effective and tailor-made solutions. For example, most OECD countries involve patients in developing safety initiatives and over 30% of them have conducted a survey on patient-reported experiences of safety.

“The use of smartphones, which we already have in our hands daily, offers a great opportunity to empower people to take charge of their own health. By providing better access to information, individuals can achieve the health results they want. Many countries and hospitals are creating patient portals to allow people to access their health records easily online,” explains Eric Sutherland.

“Using health apps to share information is fundamental in educating patients and families. These apps are common nowadays and can provide information about the condition, treatment options, and preventive measures. However, it goes beyond just giving information; it can be used for other purposes, such as monitoring and self-management through electronic symptom tracking or wearable devices that keep track of vital signs, physical activity, and other health metrics,” points out Dr Breda.

In the EU, all Member States have some form of digital service for citizens to access their health data online. However, to achieve the goal of every EU citizen accessing their health records online by 2030, accessibility gaps need to be addressed. For example, only around 50% of EU countries legally allow citizens to authorise others to access their health data and act on their behalf, which could be an obstacle for vulnerable groups such as disabled individuals.

Dr Breda adds, “Technologies can be dangerous because they can increase inequalities. Therefore, we need to think about policies that promote the equitable use of technologies and focus on reducing disparities. It’s about being people-centred and responding to individual preferences, needs, and values.”

Digital health literacy is the first step in guaranteeing equitable patient active engagement in their health journeys and ensuring that digital tools used in healthcare remain safe and functional.

The future of patient safety and digital health

Ensuring patient safety in the digital health era goes beyond adopting new technologies. It requires a comprehensive approach that puts patients and their needs at the centre, addresses potential safety risks concerning the digital environment, promotes equity to avoid exacerbating health disparities within vulnerable groups, and encourages transnational collaboration to share best practices and advance effective solutions.

As Eric Sutherland suggests, “People who have access to health information through technology should be better able to achieve their personal health goals or improve their health outcomes in a way that suits them. However, if people are not comfortable using these technologies, meaning they are not digitally literate, this is not helpful. Therefore, it is crucial to improve the digital literacy of the public to encourage the effective use of these tools for their health.”

Finally, Dr Breda comments, “I believe that keep on using digital tools to improve patient safety is crucial. There is a huge opportunity to train health professionals and patients to use digital tools to improve health outcomes. We can and should also use technology to attract young health professionals. The health sector is creative and innovative, but we don’t advertise this aspect enough to attract young, passionate professionals to embrace these professions.”