Dear Debbie and all,
Thank you for your thought-provoking reflections. I would like to pick out two points that resonate with me and comment on them below:
1. "Appropriate infrastructure and medical materials, to delivery high-quality, low-variance, individualized care to patients who are active participants in their own health"
2. "Reliable healthcare information is the biggest tool to replace the rusty scalpel for patients, clinicians, and health system stakeholders alike"
Indeed reliable healthcare information is key to patient safety and quality of care. We need increased availability of reliable information in at least three respects:
A. clinical knowledge, ranging from the most basic - such as the importance of giving a child with diarrhoea more fluids and not less - to the more complex - such as selecting an antibiotic for a severely ill patient
B. personal health record - not only by different health professionals, to ensure continuity, but also by patients
C. knowledge of patient safety principles and applications
The point about 'high-quality, low-variance' reminds me af an excellent video by Global Health Matters (WHO/TDR): Bridging the Knowledge Divide. https://www.youtube.com/watch?v=7xMSku0r7lY&t=280s
The host Garry Aslanyan interviews Joy Phumaphi, Executive Secretary of the Africa Leaders Malaria Alliance (ALMA) and former Minister of Health for Botswana.
Right at the begining he asks her: What changes have you noted about global health knowledge over the course of your career?
Here is a summary of her response, which merits attention coming from someone with so much experience and expertise:
"World Health Organization guidelines were printed, so there was essentially one main source of information. It was relatively straightforward to know what to do because you did not have to search through multiple sources or decide which information was reliable. You could rely on the WHO as the authoritative source.
"Over the past few years, however, the situation has changed considerably. There are now so many sources of health information, which can make it very difficult to know what to trust. There are centres of excellence around the world producing and sharing information, but their recommendations and data are not always aligned. As a result, different sources can provide conflicting information. In addition, there are individuals who deliberately spread disinformation, as well as misinformation that may be shared unintentionally but can be equally harmful... Overall, I feel that the situation is in some ways worse now than when I first began working in healthcare."
The key difference now is that there is uncontrolled high-variance without the ability to tell reliable information from misinformation, and with the latter presented more persuasively and malevolently.
The Global Patient Safety Action Plan would be stronger if it included a section to address these points. HIFA is currently working with the WHO to develop a technical brief on how to accelerate progress towards universal access to reliable healthcare information and I shall liaise with my colleagues to see how these points can be included and expanded.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org