How do you solve the multi-factorial healthcare dilemma?


In Australia, there is currently a dilemma facing those in the healthcare industry. Due to multiple factors, patients are receiving substandard levels of care and suffering as a result.

Preventable errors are occurring every day

In The Quality in Australian Health Care Study, over 14,000 admissions to 28 hospitals in New South Wales and South Australia were reviewed. Researchers found that:

  • 16.6% of these admissions resulted in a disability or longer hospital stay and were associated with a medical error caused by the healthcare team
  • 51% of those adverse events were preventable
  • In 77.1% of cases, the issue was resolved in a year
  • In 13.7% of cases, the disability was permanent
  • In 4.9% of cases,the patient died

more recent study further found that every year in Australia:

  • 18,000 unnecessary deaths occur as a result of medical errors
  • Over 50,000 patients become disabled as a result of medical errors

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Why do these errors occur? 

There are two main reasons medical practitioners are struggling.

  1. Available medical information is growing at an astounding rate. By 2020, information will be doubling every 73 days, and clinicians would need to read for 21 hours per day to keep up. Even if this was physically possible, this makes it extremely difficult for any medical professional to be aware of all the latest research.
  2. Medical knowledge is diffused very slowly. Only 14% of medical discoveries become standard practice, and takes up to 17 years for this to happen. This means patients are missing out on cutting-edge treatments, or are being treated with old practices.

What is the solution?

There is no easy solution to the issues described above. However, there are things medical professionals can do to put themselves in a more favourable position. At Elsevier, we believe that  providing credible, evidence-based, current information at the point of care is crucial. By combining this mind-set with technology, we can begin to move towards higher quality healthcare.

Clinical Decision Support Systems (CDSS)  

CDSS are computer systems that are designed to give specific advice to doctors and help them make the best decision. As Osheroff puts it, they “provide the right information, to the right person, in the right format, through the right channel, at the right point in workflow to improve health and health care decisions and outcomes.”

Order Sets: A Practical Application

When diagnosing and treating a patient, a physician has to account for a variety of factors including:

  • Gender
  • Age
  • Medication
  • Diet
  • Physical activities
  • Laboratory tests
  • Radiologic tests
  • Therapies
  • Treatments
  • And more

When we look at the variables above, it comes as no surprise that the physician ordering process can often be complex and time-consuming. When we add the abundance of new medical information and its slow diffusion, we can clearly see where practitioners can start to make mistakes.

With a CDSS, physicians can easily access evidence-based knowledge when they need it. But what happens when the doctor does not realise they need this information? For example, a clinician might not be aware of new technologies or practices that have recently been developed, and so he does not know to look for them.

In this instance, order sets provide a great solution, reducing medication errors by up to 81%. Based on a patient’s specific clinical history and status, order sets will automatically push all the necessary information to the physician at the point of care.


By incorporating evidence-based medicine (EBM) into a powerful CDSS and utilising order sets, the safety and quality of healthcare has the potential for vast improvements. For this to really work, we need three things:

  • Workflow-integrated and evidence-adaptive information
  • Real-time, mobile access to the information
  • Collaboration between informational technology professionals and medical practitioners

It’s our goal to partner with medical organisations to help them embrace CDSS and the possibilities of technology as an information-delivery system to address the multi-factorial dilemma that is facing healthcare in Australia. Contact us for more information.