Patient Safety Report: A Catalyst?Building Trust in Electronic Health Records
If the report's suggestions for new patient safety initiatives are carried out, those actions would help build the public's trust in the digitization of records (see: Health IT Safety: Regulations Looming?).
The report suggested that the Food and Drug Administration should regulate health information technology if stepped-up efforts to improve IT safety fail to achieve adequate results.
An independent federal watchdog agency is long overdue.
It acknowledged that some health information technologies, such as automated prescribing systems, have helped to improve medication safety. But it also concluded that studies on how electronic health records and other information technologies affect patient safety are inconclusive. "More worrisome, some case reports suggest that poorly designed health IT can create new hazards in the already complex delivery of care. ... Dosing errors, failure to detect life-threatening illnesses, and delaying treatment due to poor human-computer interactions or loss of data have led to serious injury and death," the report noted.
Consumer advocate Deborah Peel of Patient Privacy Rights was particularly pleased with the report's recommendation to create an independent federal agency, similar to the National Transportation Safety Board, to investigate patient safety issues related to IT.
"There is no question that widespread use of untested, unproven EHRs and health technologies will potentially cause injuries and deaths and different kinds of medical and human errors," Peel said in a press release. "An independent federal watchdog agency is long overdue."
I don't think it's accurate to characterize 100 percent of EHRs as "unproven," given the successful track record of so many users. But I agree with Peel's assessment that formation of an independent review agency would be good news.
It's important to remember, however, that paper-based records also raise patient safety issues. Plus, by securely sharing information in EHRs, clinicians gain better access to accurate, up-to-date information that can save lives.
Stephen Lieber, president of the Healthcare Information and Management Systems Society noted in a statement about the report: "The paper-based health system, still in use in many clinical practices and hospitals across our nation, has profound deficiencies in failing to portray a full and up-to-the-minute picture of patients' conditions and care. The paper-based health system kills."
The leader of the association for IT executives also said: "HIMSS strongly believes that electronic health records - effectively implemented using best practice change management protocols in a transparent fashion, and providing comprehensive training to users - have tremendous promise." And I strongly agree.
HIMSS acknowledged that the use of EHRs can be made safer and committed to working with the Institute of Medicine and others on the patient safety issue.
As a result of the HITECH Act, the federal government is committed to spending billions of dollars on financial incentives for physicians and hospitals to use EHRs. Surely, we can afford to spend some of that HITECH money on research about patient safety, as well as privacy and security issues.