Implementation of the Australian National Safety and Quality Digital Mental Health Standards

OBJECTIVE

Following the release of the Australian National Safety and Quality Digital Mental Health (NSQDMH) Standards in November 2020, our objective was to ensure effective implementation of the Standards. This included the development of an accreditation scheme to allow digital mental health services to be formally assessed against the Standards and provide service users with an assurance of safe and high-quality services.

METHOD

The accreditation scheme was adapted from the one used for the National Safety and Quality Health Service (NSQHS) Standards. As the digital mental health sector was largely unfamiliar with standards and accreditation, the scheme was pilot-tested with a range of service providers and further consultation took place to refine it.

RESULTS

The accreditation scheme was launched in November 2022 with support resources published to aid implementation.

CONCLUSIONS

The NSQDMH Standards accreditation scheme provides an assurance of safety and quality for digital mental health service users.

Usefulness of linked data for infectious disease events: a systematic review

Surveillance is a key public health function to enable early detection of infectious disease events and inform public health action. Data linkage may improve the depth of data for response to infectious disease events. This study aimed to describe the uses of linked data for infectious disease events. A systematic review was conducted using Pubmed, CINAHL and Web of Science. Studies were included if they used data linkage for an acute infectious disease event (e.g. outbreak of disease). We summarised the event, study aims and designs; data sets; linkage methods; outcomes reported; and benefits and limitations. Fifty-four studies were included. Uses of linkage for infectious disease events included assessment of severity of disease and risk factors; improved case finding and contact tracing; and vaccine uptake, safety and effectiveness. The ability to conduct larger scale population level studies was identified as a benefit, in particular for rarer exposures, risk factors or outcomes. Limitations included timeliness, data quality and inability to collect additional variables. This review demonstrated multiple uses of data linkage for infectious disease events. As infectious disease events occur without warning, there is a need to establish pre-approved protocols and the infrastructure for data-linkage to enhance information available during an event.

Health Outcomes and Healthcare Efficiencies Associated with the Use of Electronic Health Records in Hospital Emergency Departments: a Systematic Review

Healthcare organisations and governments have invested heavily in electronic health records in anticipation that they will deliver improved health outcomes for consumers and efficiencies across emergency departments. Despite such investment, electronic health records designed to support emergency care have been poorly evaluated. Given the accelerated development and adoption of information technology across healthcare, it is timely that a systematic review of this evidence base is updated in order to drive improvements to design, interoperability and overall clinical utility of electronic health record systems implemented in emergency departments. To assess the impact of electronic health records on healthcare outcomes and efficiencies in the emergency department we carried out a systematic review of published studies on this topic. This is the first review to summarise the cost efficiencies associated with electronic health record use outside of just the United States of America. A systematic search was performed in three scientific databases (MEDLINE, EMcare and EMBASE), of literature published between January 2000 and September 2019. Studies were included in this review if they evaluated electronic health records or health information exchanges (and synonyms for these terms), reported patient outcome and/or healthcare efficiency benefits, were peer-reviewed and published in English. Out of 6635 articles, 23 studies met our inclusion criteria. Wide variation regarding electronic health record access in the emergency department was reported (1.46-56.6%), yet was most frequently reported as less than 20%. Seven different types of health outcomes and three different types of efficiency improvements associated with electronic health record use in the emergency department were identified. The most frequently reported findings were efficiencies, including reductions in diagnostic tests, imaging and costs. This review is the first to report moderate to significant increases in admission rates are associated with electronic health record use in the emergency department, contrasting the findings of previous reviews. Diversity in the methodology employed across the included studies emphasises the need for further research to examine the impact of electronic health record implementation and system design on the findings reported, in order to ensure return on investment for stakeholders and optimised consumer care.

Telephone follow-up calls for older patients after hospital discharge

Population ageing poses many challenges. Recurrent readmission to hospital by frail older people places a strain on health systems and the individual. Registered nurses with experience in emergency department, ICU and aged care conducted telephone follow-up calls to patients or bereaved family members after an acute hospital admission. During follow-up calls, many patients reported feelings of loneliness and social isolation post-discharge. It was also found that patients may not be aware of support services available in the community. Telephone follow-up calls after discharge is a potentially cost-effective strategy to identify these patients and potentially provide comfort and timely referrals where needed.