“The next challenge is to implement standardised electronic surveillance of AMR and HAIs in more than 8,000 European acute care hospitals, the ECDC is ready to help make this happen.”
Andrea Ammon, Director of the European Centre for Disease Prevention and Control (ECDC)
On 2nd October 2019, Health First Europe organised the “Data for safer care” workshop at the European Health Forum Gastein to explore the disruptive role of data in shaping effective patient safety strategies and develop effective healthcare-associated infections’ (HAIs) surveillance systems.
The moderator of the session Dr Josep Figueras, Director of the European Observatory on Health Systems and Policies , introduced the topic highlighting the potential of data-driven solutions for safer care and the EU’s role in sharing relevant data on patient safety as well as guiding member states to developing a common strategy to improve patient safety.
Data collection and surveillance strategies are needed to foster patient safety and tackle 8.8 million cases of HAIs in EU, along with the threat posed by antimicrobial resistance (AMR). HAIs are a severe threat to patient safety and the most frequent adverse events during care delivery: a total of 228.000 acute care hospital patients and long-term facility residents acquire at least one HAI in any given day in the EU (1 in 15 patients and 1 in 26 residents). Comparable and aggregate data should be collected to guide efficient and transparent patient safety programmes, structures and policies. To facilitate mutual learning, common indicators need to be developed through cooperation between Member States and the European Commission, considering the work of relevant international organisations.
Keynote speakers opened the discussion by sharing their expert opinions on the potential of surveillance systems along with their perspectives on the barriers to their effective implementation. The first part of the debate focused on the main barriers to the implementation of data-driven solutions for safer care, from infrastructures to investment. Federico Lega, President of the European Health Management Association (EHMA), stressed that one of the most important missing pieces is a common vision and commitment to make safer care a strategic, operational and ethical priority. This also means to work across settings to improve data quality and boost leadership for the uptake of data-driven solutions and the use of electronic records.
With respect to the infrastructural barriers to effectively implement electronic surveillance systems, many participants highlighted the differences between hospitals’ software and the resulting lack of interoperability to connect and communicate amongst systems. On data collection and sharing tools, Paul Garassus, President of the European Union of Private Hospitals (UEHP), emphasises that strategic investments in IT are required to develop ‘smarter hospitals’ to improve efficiency in data and patient records exchange between family doctors and private and public hospitals. In addition, many delegates attending the meeting raised the point of differences in terminology, methodology and legal barriers. Health care settings often have access to a massive amount of data without the right insights for interpreting and translating them to enable improvement actions.
Behind those challenges, we can count on many drivers and champions to make AMR and HAI surveillance systems across Europe a reality, starting from the European Centre for Disease Prevention and Control (ECDC). “We are ready to help make this happen in more than 8,000 European acute care hospitals”, stated Dr Andrea Ammon, ECDC Director.
Looking at the drivers for the correct implementation of surveillance systems, participants stressed the importance to promote a ‘safety culture’ in health care settings and the need to put patients’ experience at the heart of infection prevention and control programme. Fiona Garín McDonagh, from Becton, Dickinson and Company (BD), emphasised how patient experience is “at the heart” of what health care aspires to be, adding that “healthcare-acquired infections negatively disrupt this experience. Strong leadership, an effectivepatient safety culture and innovative technology can go a long way in preventing a large percentage of infections and diseases.”
A better use of data and investment in infrastructures starts from political commitment. Neda Milevska, from the International Alliance of Patients’ Organizations (IAPO), stressed that “through a strong political commitment, a large share of HAIs can be prevented with simple and effective measures”, advocating for an easier access to data for patients across Europe, allowing them to be actively involved in their health decisions.
A first step for achieving a common vision and political commitment, at least to tackle AMR, has been the creation of the EU-JAMRAI, the EU Joint Action on AMR and HAIs, aiming at fostering synergies amongst EU member states by developing effective health policies. Germán Peñalva, researcher at the EU-JAMRAI and the Institute of Biomedicine of Seville (IBIS), presented the preliminary results of the Joint Action and stressed that “timely, regular” monitoring of indicators related to HAIs is a “key factor to design, implement and improve prevention and control strategies. Yet, this monitoring requires professional leadership and institutional support.”
The second part of the workshop aimed at facilitating the exchange of national best practices amongst the participants of the debate. Fernando Simón, director at the Centro Coordinador de Alertas y Emergencias Sanitarias of the Spanish health ministry (CCAES), explained how in Spain developed a brand-new surveillance system, to collect and exchange smart health data across hospitals, boosting efficiency and reducing errors. On the same line, Sinikka Salo, from the Finnish Ministry of Social Affairs and Health, described how “ICT, big data and new technologies, like AI, represent an opportunity to improve patient safety”. She also added how “the EU could promote the creation of common reporting standards and common platforms for the collection and sharing of information”; a best practice example is a Finnish online platform to anonymously report medical adverse events, where instead of “blaming people”, hospitals collect data to improve patients’ treatment and compensate them.
Concluding the two-hour debate, Melina Raso, Director of Health First Europe, called for a joint vision and joint effort of all the health care stakeholders to push for a strong political commitment for safer care in order to tackle HAIs, the most common adverse events in health care settings. The demand comes 10 years after the adoption of the 2009 European Council recommendation on patient safety, Ms Raso highlighted the need to move gradually from disease surveillance systems based on notifications by health care professionals to systems that make direct use of health care data. This will occur only with a greater understanding of data-driven innovation tools for safer care along with the involvement of the political, public health and societal actors.