Issue link: https://viewer.e-digitaledition.com/i/125940
Nationa l Coordinator for Hea lth Information Technology (ONC) issued a draft "Health Information Technology Patient Safety Action & Surveillance Plan" for comment. The plan contains specific recommendations and actions for the Department of Health and Human Services (HHS) to support EHRs' potential to enhance safety, both at the individual and public health levels. The plan also contains provisions designed to identify, track and curtail safety issues associated with EHRs. Recommendations include robust steps for HHS to raise physician awareness of safety issues associated with EHRs and make it easier for physicians to report safety concerns and real or potential hazards. In particular, the ONC aims to include health care IT vendors in the safety puzzle. Backed by the FDA Safety and Innovations Act of 2012, the ONC and FDA share responsibility to create a regulatory framework for health care IT. Specific recommendations include: + implementation of a surveillance plan, published by HHS, on "the impact of health IT on patient safety" a n ot h e r s e t oF e yes HE alt H Ca RE inf OR matiO n technology ts by: can help protect patien ties introduced by + eliminating uncertain poor handwriting scription errors + flagging potential pre ers + issuing safety remind ations for various + performing equ t-based dosing purposes, such as weigh tion in the case + providing vital informa ommunicative of an unconscious or unc patient nt reminders and + updating appointme interactions spurring other patient + free exchange of data about safetyrelated health IT experiences and concerns and, in particular, a reporting mechanism established by HHS for making public health IT-related injuries, deaths and unsafe conditions + creation of an independent entity to investigate and report safety concerns related to health IT. Professional medical and health care informatics associations applaud the draft resolution, especially considering the ONC seems determined to place more responsibility for products' functionality in the laps of health care IT developers and vendors. In response, the American Hospital Association adds the desideratum of a single-patient health record identifier to promote consistent, accurate exchange of patient data, while the American Medical Informatics Association urges greater consideration of the human "usability" aspects of health care IT systems as key to increasing patient safety and improving quality of care. Physicians, even those who are satisfied with their EHR systems, may welcome a clearer articulation of responsibility. "It's a valid thing to track," says George M. Miller, M.D., M.S.H.A., FACS, general surgeon at Grenada Lake Medical Center, who, like many doctors, has seen potential errors averted due to his electronic record-keeping system. "My EHR tends to err on the side of being overly safe." In today's litigious medical environment, physicians may want to keep their eyes on the potential of health care IT to cause harm. Governmentregulated IT systems could reduce a n ot h e r oF error set s HE al tH Ca RE in fO Rm at iO n technolo gy rors in the follo wing ways. + Data may be entered in the wrong fields or keyed incorrectly. + Drop-down menus make it easy to select the wro ng item. + fields may reset to defaul t values. + order sets and other data can be blindly "cut an d pasted" from one day to the next with out updating. + systems ac ross a hospita l or health system may no t communicate data correctly, or at all. can lead to er the possibility of medical malpractice lawsuits by helping physicians prove their EHR and other systems were certified and used according to the latest, nationally recognized safety standards, writes Sharona Hoffman, J.D., LLM, Edgar A. Hahn Professor of Law, professor of bioethics, and Co-Director of the Law-Medicine Center at Case Western Reserve University. "EHRs were promoted as saving costs and preventing mistakes," says Hof f ma n. "Physicia ns should be aware that EHRs also create new opportunities for error. They should be conscientious about training themselves and their staffs and should be aware of typical sources of problem situations, such as copy-and-paste functions. If they do detect potential problems, they should contact their vendors immediately." Ha v e y o u e v e r b e e n a w a r e o f a clinically unsafe situation caused by an electronic health record? Join t h e @M D N e w s N e t w o r k d i s c u s sion on Twitter using the hashtag #MDNsaferEHR. mdnEwS.COm ■ MD News Greater Boston | 17