Occupational Therapy News OTnews October 2019 | Page 55

TECHNOLOGY FEATURE Digital tools and risk enablement systems team in 2017 as an analyst. ‘I soon took over the role of clinical safety officer for my organisation. As an occupational therapist, my understanding of the patients’ pathway through services, experience in clinical risk assessment, skills in activity analysis and understanding of how the person adapts to and engages with their environment have all impacted on how I have performed these clinical risk assessments. ‘How system functionality is used in different environments (for example, a patient’s home or busy ward) can influence how it is configured and the different risks associated with its use. ‘Clinical systems can be complicated and they do not do everything we need them to do. All too often “user error” is blamed and “training” is prescribed. There is a growing need for further human factors/ergonomic assessment in both the design and implementation of health IT, so that design is more user friendly and reflects clinical need.’ In addition to the electronic record, another big change impacting on practice is the move towards increasing ‘digital access’ to health and care. For occupational therapists that are exploring the provision of digital appointments, home visits or groups, for example, they may find the risk enablement process alongside their local policy and procedures useful. In summary, when exploring the use of digital technologies, there is a balance to be had. Occupational therapists have the skills to embrace and be part of targeted digital projects. Example: evaluating apps The NHS app library contains products that have been through a rigorous assessment of an extensive range of standards and regulations and is a good place to start if you wish to recommend an app to someone you are working with clinically. You then need to consider if the app will be used in the same or a similar context and document your reasoning and recommendation clearly. We know that use of tools such as apps improves if it is ‘activated’ by a clinician sitting alongside them, to support that early engagement. This just means taking time with the person who will use it to help them get set up and try some of the functions. At this point you will also be assessing potential risks and mitigations, the context in which the person is likely to actually use the app and other occupational factors. For example, a vulnerable person may be at risk of bullying or abuse if they do not protect their privacy in the app via a pin/password. This would be a clinical safety hazard if the developer has not considered this and built the functionality to enable this to be set up. If content is added that is highly personal and it is lost, or the app unavailable to refer to, what is the clinical risk to the person or a population of people? Alicia Ridout, occupational therapist References https://bit.ly/2C5KTjl [accessed 30 September 2019] RCOT (2018) Keeping records: Guidance for occupational therapists. Available online at: https://bit.ly/2AR502R [accessed 30 September 2019] Suzy England, RCOT professional adviser. If you work in patient/ citizen safety roles with digital technologies across the four nations of the UK, email Suzy at: [email protected] How to improve success of technology projects in health and social care. Available online at: https://bit.ly/2nK2OH7 Clinical safety: https://digital.nhs.uk/services/ solution-assurance/the-clinical-safety-team RCOT (2017) Embracing risk, enabling choice. Available online at: OTnews October 2019 55 Occupational therapists working with digital tools have found RCOT’s Embracing risk, enabling choice (2017) guidance a useful resource for understanding the risk enablement process. The guidance states that: ‘Risk assessments should be made and an enablement plan put in place when any significant changes are proposed to systems or practices, when any new project or activity is planned, and before any particular actions or interventions are made that may engender risk.’ A big change impacting on many health and care services across England is the move from paper to electronic records. A number of occupational therapists have been involved in electronic record implementation programmes. For example, the role of the clinical safety officer is to perform this risk assessment. Occupational therapist Dee Baker says: ‘With no “tech” background and only a desire to understand how electronic care records are configured and how this impacts on information flow, I left my therapy lead job and joined my clinical