7 considerations for using the GM Care Record safely
What providers should consider under DCB0160
By Darren Biega, Clinical Lead Nurse Innovation – Digital, Health Innovation Manchester
Regional clinical safety assurance supports local deployment, but it does not remove the need for providers to consider the clinical risks arising from how GM Care Record is implemented and used within their own organisation.
The GM Care Record (GMCR) provides health and care professionals with access to information from across care settings to support more informed and coordinated care. However, introducing or using digital technology within a clinical environment is not simply a technical implementation. It also requires consideration of how the technology interacts with local people, processes, workflows and existing systems.
This is where DCB0160 – Clinical Risk Management: its Application in the Deployment and Use of Health IT Systems – becomes particularly important.
DCB0160 applies to health organisations responsible for the deployment, use, maintenance or decommissioning of health IT systems. Its purpose is to ensure that clinical risks associated with implementing and using health IT are properly identified and managed.
A shared regional safety case
Clinical safety assurance for the GMCR has been undertaken by Health Innovation Manchester (HInM) on behalf of the Greater Manchester Integrated Care Board (GMICB) and is documented within the GMCR Clinical Safety Case Report and associated Hazard Log. These provide the overarching clinical safety evidence for the GMCR and a foundation to support safe local deployment. However, Provider organisations should consider this evidence within their own clinical risk management arrangements and determine how it should be incorporated into their local clinical safety documentation and assurance processes.
While this regional assurance is an important starting point, every organisation is responsible for understanding how the GMCR will be used within its own services and clinical workflows. The way information is accessed, interpreted and acted upon may vary between organisations, and this can introduce local risks that are not fully addressed by the regional assessment alone.
Organisations should therefore undertake their own DCB0160 clinical risk management activities to identify any organisation-specific hazards, governance requirements, operational processes, training needs and safety controls associated with their use of the shared care record. This should include consideration of the risks and mitigations already identified within the GMCR Clinical Safety Case Report and Hazard Log, together with any additional local risks arising from implementation and day-to-day use.
What 7 things should providers consider?
Clinical safety needs clear organisational ownership. Providers should ensure that a suitably trained Clinical Safety Officer is appropriately involved in considering how the GMCR will be deployed and used within the organisation.
The same technology may interact differently with different clinical services and workflows. Providers should consider the intended local use of the GMCR, including how staff will access and interpret information and how GMCR interacts with their existing clinical processes.
Providers should make use of the clinical safety documentation available for GMCR rather than starting their assessment without reference to the regional assurance work. Manufacturer assurance under DCB0129 informs this assessment, while DCB0160 addresses the responsibilities of the organisation deploying and using the system.
Providers need to consider whether their particular deployment introduces risks that are not fully addressed by the regional GMCR safety case. Local assessment should reflect the organisation’s services, workflows, technical configuration and use of the information presented through GMCR.
Safe implementation relies on more than the technology itself. The GMCR safety case identifies training and clinical processes, User Acceptance Testing, Business Continuity Plans and incident-management and reporting arrangements among the considerations for deployment.
Clinical safety is not a one-time activity. Organisations should maintain appropriate clinical safety oversight throughout the lifecycle of the GMCR, ensuring that changes, upgrades and decommissioning activities are assessed and managed safely.
Staff should understand how to escalate potential digital clinical safety concerns. The GMCR safety case identifies organisational incident-reporting systems, escalation arrangements and IT Service Desk reporting as elements of the safety arrangements around the system. A potential GMCR clinical safety issue should therefore be treated as a patient-safety concern, not simply as a technical fault and should be escalated in accordance with the organisation’s incident reporting processes
A shared responsibility for safer digital care
The over-arching GMCR clinical safety case provides an important Greater Manchester-wide foundation for safe use of the system. Local organisations, however, must undertake their own DCB 0160 with their own clinical environment and ensure all known hazards and risk are recorded and communicated.
Organisations should ask themselves:
“Have we considered how GMCR can be safely deployed, used, maintained and, eventually, decommissioned within our organisation?”
Embedding that thinking into implementation, governance and business-as-usual processes helps make clinical safety part of everyday digital practice rather than an exercise completed only at deployment.
Further information
DCB0129 and DCB0160 are being reviewed nationally.
Organisations should use the current published standard and guidance when undertaking local clinical risk management activity.
