Meet Healthcode’s Clinical Safety Officer

Tell us about your job?

Healthcode were looking for a Clinical Safety Officer last year to oversee risk management and ensure the safe design and deployment of their systems. This hadn’t been necessary while their focus had been on back-office operations like invoicing but the next generation of ePractice changed everything as it allows providers to manage the whole patient journey, including frontline tasks like prescribing.

The team was determined not to compromise on patient safety, but another factor was that they wanted these new clinical features to be accessible in NHS settings. The NHS rightly expects IT systems providers to demonstrate compliance with its own standards, including the DCB0129 standard for clinical risk management.

With this in mind, Healthcode contacted my company, ETHOS Ltd, which specialises in helping healthcare innovators achieve regulatory compliance with DCB0129. We’re supporting the team all the way to meeting NHS standards, and as Head of Clinical Safety at ETHOS, I was delighted to get on Healthcode’s Clinical Advisory Board as their CSO.  

What’s your own background and how do you bring your previous clinical experience to the role?

I have 20 years’ experience in healthcare IT and patient safety, qualifying as a Clinical Safety Officer in 2007 and with a PhD in Bioinformatics. My clinical background is in medical imaging: I practised as a Radiographer in New Zealand and several NHS Trusts in the UK and I’m registered with the Society of Radiographers.

The nature of radiography means that risk assessment is always at the heart of the process. The first thing you learn as a student radiographer is not to take an X-ray unless it’s clinically required so there’s always that mentality about putting the patient first and assessing the risks and benefits.

Another important factor is that radiography is central to nearly everything that’s going on in a hospital: you have to know who’s ordering images and why, who needs to sign-off on certain x-rays and who’s responsible for assessing images and writing reports. That hands-on understanding of organisational workflow is the biggest bonus that I’ve been able to bring to my clinical safety role.

What progress have you made towards meeting clinical risk standards?

Healthcode is an established organisation so luckily, we weren’t starting from base camp. It’s largely been about aligning their development processes with the DCB0129 safety standards and embedding a culture of clinical safety.

We’re following a risk management process compliant with DCB0129: looking at the deliverables for each project, risk assessment and reporting. It’s my responsibility to ensure that we respond correctly to risks and identify where additional controls need to be implemented to mitigate risk.

Digital prescribing within ePractice is already live – that’s been a priority. I’ve completed a baseline risk management report, and the next task is to create a Delta Report to analyse how changes like NHS deployment could introduce additional risks, including the interface and any new functionality.

It’s also important that we continually look at new and changing safety risks and address these as we move through the product life cycle. It’s like when you have your car MOT – it’s a baseline but you still need to regularly top up the oil, check the tyres, brakes and so on. To support this, I’ve created a visual system that flags potential risks to patients and I’m writing a clinical risk management plan which sets out how the organisation should respond to reported hazards. It covers how these are assessed and prioritised and added to the development team’s work list.

How can CSOs help tech companies like Healthcode balance innovation with patient safety?

A CSO isn’t there to slow the organisation down and make it so difficult to innovate that they just give up or do something unsafe. Instead, you need to work closely with development teams and product owners to understand what they’re currently doing and ensure patient safety is at heart of the software build process.

Ultimately, a lot comes down to a risk-benefit analysis of new functionality. If technology is going to be used in a way that directly influences patient care, you’d need more checks and balances built into the system than if it’s being used as a tool to reduce admin.

How does a CSO make a difference for patients?

I’m a clinician and my role as CSO is to ensure we put patients first when thinking about the patient journey and the health systems that support that journey. With electronic prescribing, for example, we’d look at what data is needed for clinicians to prescribe safely, the secure system interfaces required to collect accurate data exactly when it’s needed and how to share data to ensure effective continuity of care.

That holistic approach is important for patient care and their experience of the service because nobody wants to feel they’re stuck in a system, waiting for a call. If people start to feel that something isn’t working for them, they simply won’t use it, so we must ensure safety and useability are at the core of everything we do now and for the future.

What do you like most about working with the Healthcode team?

The best thing is that everyone is very open to change. A lot of organisations in the healthcare sector can be quite set in their ways, but Healthcode wants to innovate. In my 20 years in the tech field, there’s almost always someone who pushes back because they don’t want to try another way. Every time I come to the Healthcode office, everybody is keen to engage and interested in clinical safety. That attitude runs throughout the entire organisation.

And finally, how do you switch off when not at work?

My three kids keep me busy but in my spare time I stay fit with boxing. I go to a gym near London Bridge which is a proper, old-school place where the professional boxers go. As an older enthusiast I just do a little bit of sparring and pad work, rather than competitive boxing, but it’s a sport that I’ve always been drawn too. When I was growing up, I enjoyed watching the great fighters like middleweight champion Marvin Hagler, but the more recent match between Anthony Joshua and the YouTube star Jake Paul was an interesting example of how the sport is changing to bring in new fans.