As physicians and hospitals implement electronic health record systems in light of financial incentives from the federal government, experts are considering how to ensure patient safety when working with health information technology.
The Health IT Policy Committee, which makes recommendations to the federal National Coordinator for Health Information Technology, met this spring to discuss areas where potential patient safety hazards exist. Topping the list were technology issues such as software bugs, interoperability problems, and implementation and training deficiencies. Another major area of concern is the interaction of people and technology.
According to Paul Egerman, cochair of the Health IT Policy Committee's Certification/Adoption Workgroup, straightforward technology problems are in the minority when it comes to safety issues. Once these problems are discovered, they can usually be easily and rapidly fixed.
Most safety issues surrounding health IT involve multiple factors. That complicates things, Mr. Egerman said, because even if the technology worked perfectly, there could still be problems. “There are tons of issues that are completely independent of technology,” said Mr. Egerman, CEO of eScription, a computer-aided medical transcription company.
Also of concern is that many of the health IT–related safety issues are local. Marc Probst, cochair of the Certification/Adoption Workgroup, said that each health care organization is unique, and relies on very different operating systems, security and privacy protocols, and types of monitoring. That puts the onus on individual organizations to stay on top of safety issues raised by their health IT systems, he said.
“Every organization is going to be unique, so there is a local responsibility to HIT safety that our vendors simply aren't going to be able to keep up with,” said Mr. Probst, chief information officer at Intermountain Healthcare in Salt Lake City.
The workgroup recommended that patients play a greater role in identifying errors, and called for the establishment of a national database and reporting system that would allow patients and providers to make confidential reports about incidents and potential hazards.