Patient safety has become an important theme of the research agenda in the course of the last decade, both throughout Europe and worldwide. Improving patient safety and the quality of healthcare poses many challenges, and information technology (IT) has always been seen as having the potential to support the measures necessary to address these. But the risk of adverse events is unfortunately rising alongside the increasing sophistication and maturity of the health IT systems incorporated into the hospital environment. One major source of such errors is related to medication, i.e. adverse drug events (ADEs), which can incur considerable extra healthcare costs, as well as posing a risk to the safety of patients.

From a research perspective, different approaches have been introduced to eliminate ADEs, such as reporting systems, records and chart reviews, detection methods (with varying degrees of automation), etc. The major concerns raised by all of these approaches and methods are related to reliability and quality of results, reproducibility or generalisation of the conclusions drawn, appropriate identification of the contributing factors and interpretation of the outcomes, and knowledge management.

From a practical perspective, the transferability and use of such tools in clinical practice is a major challenge. Aspects related explicitly to the healthcare environment have to be taken carefully into account, such as organisational and procedural parameters, contextualisation issues, human factors and usability features, to name but a few. The adoption of these tools into real clinical settings is only possible by means of a holistic, validated and qualitative approach.

Following the success of the first workshop, organised in the context of the EU-funded Patient Safety through Intelligent Procedures in medication (PSIP) project and held in Belgirate, Italy, in September 2009, this second workshop presents current, novel methods and applications that have achieved concrete results and that are relevant to the domain of patient safety as a whole. Reading the papers of this book, which review the state-of-the-art, it is evident that significant progress has been made in the field, but that even greater challenges must still be faced if a successful transfer of research ideas and outcomes into clinical practice is to be accomplished. It is the diversity of these challenges and the complexity of the domain which indicate and justify the necessity to introduce a new direction in healthcare IT devoted to patient safety per se. Hence the title of this book: “Patient Safety Informatics”.

To this end, the contributions in this book include: (a) designing IT systems for patient safety, coping in particular with information contextualisation, human factor engineering, the design aspects of clinical decision support systems, and e-prescription frameworks; (b) methods and technologies for developing patient safety systems, devoted to medical information extraction via semantic mining techniques, multiterminology systems linked with semantic interoperability, knowledge representation techniques and standardisation aspects, etc.; (c) novel applications of patient safety informatics, such as an ADE retrospective analysis framework, the exploitation of decision support services for ADE prevention via a variety of systems (i.e. a commercial electronic health record, a commercial computerised physician order entry system, and an autonomous web-based platform), a standardised patient summary framework, a terminology mapping framework applicable in several domains, etc., and (d) validation and impact assessment studies for patient safety informatics outcomes, analysing in particular patient empowerment solutions, clinical decision support systems and knowledge bases targeting ADE prevention, an ADE retrospective analysis system, medical information extraction from discharge letters, etc.

In addition, this workshop is an opportunity for experts active in the field, including the contributors to this book, to meet and confront ideas and experiences arising from many different perspectives, i.e. research, clinical practice and healthcare IT industry oriented, as well as from several EU projects funded to contribute to patient safety as a whole.

We would like to express our gratitude to Prof. David Bates, Prof. Jos Aarts and Dr. Beth Lilja for their participation and their keynote speeches; to Mr. Michele Carenini, Prof. Peter Elkin, Dr. Zoi Kolitsi, Prof. Andre Kushniruk and Prof. Gianluca Trifirò for accepting the invitation to participate in the Workshop; to all the participants and the authors of the Workshop; to the Scientific Committee and the reviewers who helped in the preparation of qualitative contributions in the Workshop and, last but not least, to the European Commission which, by funding European projects in the domain of patient safety, have made the organisation of this workshop possible, as well as the editing and publication of this book.

The book cover is inspired by the paper entitled “Implementation of a Taxonomy Aiming to Support the Design of a Contextualised Clinical Decision Support System” by Stéphanie Bernonville, Romaric Marcilly, Radja Messai, Nicolas Leroy, Emma Przewozny, Nathalie Souf and Marie-Catherine Beuscart-Zéphir which is published in this book (pp. 74–83). The picture denotes the design approach proposed by the authors for developing contextualised clinical decision support systems (CDSS) for medication safety.

Vassilis Koutkias, Julie Niès, Sanne Jensen, Nicos Maglaveras and Régis Beuscart

(editors)

May 2011