In order to advance health IT safety, healthcare industry stakeholders need to launch a coordinated effort, supported by public and private sector funding, to set health IT safety priorities and measure progress, drawing upon existing reporting and analysis efforts, according to a new Bipartisan Policy Center report.
The report, “Patient Safety and Information Technology: Improving Information Technology’s Role in Providing Safer Care,” explores the intersection of patient safety and IT, assesses progress made, and makes policy recommendations for implementing a health IT framework that both protects patient safety and promotes innovation.
More than 15 years ago, the Institute of Medicine released two landmark reports that catalyzed efforts to improve patient safety and quality in the U.S. health care system, the report notes. Both reports, To Err is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, highlighted the critical role that health information technology (IT) plays in improving the safety and quality of health care.
Since that time, the report notes, more than $36 billion in federal investments have been made in electronic health records with the goal of improving health and health care. As a result, the use of health IT is now widespread, with 88 percent of hospitals and 87 percent of physicians now using an electronic health record (EHR), according to the Office of the National Coordinator for Health IT (ONC).
“Numerous studies have shown that health IT reduces medication errors, improves quality outcomes, and reduces the cost of care. However, there are instances in which health IT has the potential to create harm if not effectively developed, implemented, or used. Several steps have been taken by Congress, the executive branch, and the private sector to advance an oversight framework for health IT, but additional actions are needed,” the report authors wrote.
Preventable harm to patients is one of the leading causes of death in the United States. Multiple studies indicate that more than 200,000 Americans die each year from preventable medical errors, ranking third behind heart disease and cancer, the report states. Examples of harm include medication errors, missed or delayed diagnoses, and avoidable delays in treatment and response to abnormal tests.
The Bipartisan Policy Center report was developed through a comprehensive literature review, as well as interviews and roundtable discussions with 40 experts and stakeholders. BPC offers a number of recommendations that can be implemented in the near term to advance patient safety in the development, implementation and use of IT.
Regarding the need for a coordinated public-private leadership effort, BPC recommends that the federal government should direct research grant funding, which should be matched by private sector funding, to an independent, non-profit entity to launch and operate a coordinated effort to support improvements in health IT safety and the safe use of health IT.
The BPC report also notes that several best practices and tools that help address safety issues exist but are not widely adopted. To this end, BPC recommends that organizations, whether developers, implementers or users of health IT, should accelerate the widespread dissemination of existing best practices and tools that address priority safety issues and coordinate efforts to address gaps.
Further, BPC also recommends that industry stakeholders continue to advance development and adoption of standards.
“Existing standards and other organizations operating as independent, voluntary consensus bodies should stay informed of priority safety issues that arise from the coordinated effort, and—as needed—facilitate agreement on baseline, evidence-based standards related to safe health IT products and safe use of health IT,” the report states. “The federal government, including ONC’s Health IT Certification Program, should recognize and rely upon such standards in any health IT-related safety efforts.”
Further, the report authors also recommend that accreditation and certification bodies should incorporate such standards into their programs to support adherence. The ONC Health IT Certification Program should also assure that current certification requirements are enforced, particularly those focused on safety.
Janet Marchibroda, BPC’s director of health innovation, said that the report is not calling for more regulation, but rather puts an emphasis on public-private sector collaboration. “The 21st Century Cures Act laid the groundwork for an oversight framework for health IT by providing much-needed regulatory clarity. The next step requires action on the part of both the private and public sector—who must work together to create an environment of learning and improvement,” Marchibroda said.
“Improving information technology’s role in providing safe care is a shared responsibility among those who develop products and those who use them,” Senator Bill Frist, M.D., said in a statement. “Understanding where the problems are through a non-punitive learning approach, and then working together on actionable solutions will improve patient safety in our health care system.”
“Improving safety in the development, implementation, and use of health IT requires three primary strategies,” Rep. Bart Gordon said. “These include using data to understand the nature of the problem, developing and driving the adoption of standards, and promoting widespread use of best practices.”
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