A recent blog-fueled debate has fired up surrounding the overall effectiveness of EHR technology. While critics and supporters debate the benefits and costs of EHRs, some are talking about possible safety risks associated with the technology and infrastructure that has emerged within the past few years.
Fred Trotter, a Hacktivist for the Cautious Patient Foundation, warned in a speech at the 2012 SXSW Interactive Conference that healthcare IT, much like the early auto industry, is at a point where mistakes and systems failures will cost lives.
“Electronic health care records will be killing people over the next five years,” he said. “Just grow comfortable with that.”
Trotter first emphasized this point in a blog post on O’Reilly Radar website back in January.
“Cars have been killing people for years. They kill even more people as they become more popular and available. All of a sudden, the same kind of dramatic talk sounds pretty tame.”
Dean Sittig, a researcher at the University Of Texas School Of Biomedical Informatics in Houston, echoed this sentiment while testifying before an Institute of Medicine panel last year.
“EHRs are like cars. They’re inherently a good thing, but they need some seatbelts, wipers and headlights to make them safer. And we’re not there yet,” he said.
The IOM published a November 2011 report based on that panel titled “Health IT and Patient Safety — Building Safer Systems for Better Care.” That report concluded EHRs have yet to confer significantly measurable patient safety gains.
The report said that some elements of EHRs are increasing patient safety. The number of patients who receive the correct medication in hospitals increases when well-planned, robust e-prescribing systems are in place. The report also discusses the dosing errors, systems failures, and delayed treatments that have led to serious injury and death.
These concerns, along with increasing EHR complexity and aggressive adoption timelines, have led to calls for an EHR safety oversight program. Dr. Hardeep Singh, of Houston VA Health Services, along with Sittig and his University of Texas colleague David Classen, wrote about just such a program in the November edition of the Journal of Patient Safety.
According to the new report, “Creating an Oversight Infrastructure for Electronic Health Record-Related Patient Safety Hazards”, an EHR safety program could mandate, collect, and analyze safety data generated by providers or vendors. Based on this data, the program could publish ratings and recommendations for the purchase and use of EHRs.
To support the new national safety board, institutional EHR safety committees, including a designated EHR patient safety officer, would investigate, analyze, and report all known safety incidents in an organization and perform routine safety audits. The board could also develop and maintain EHR safety metrics and guideline for providers to follow.
“The board would work closely with EHR certifying organizations (and thus indirectly with EHR vendors) to improve EHR design and implementation, and with other government agencies (such NIST and ONC) to coordinate EHR-related rules and regulations,” the authors wrote.