At the end of 2014, the Center for Medicare and Medicaid Services reported that 50,000 fewer patients died from medical mistakes while in the hospital. Better use of health information technology was a major reason.
HIT could be equally successful in other settings, where most health care is provided, according to Tejal K. Gandhi, MD, president of the National Patient Safety Foundation.
Among the challenging areas Gandhi said HIT could target are medications, transitions in care and diagnostic errors. She also called attention to HIT alarm fatigue caused by near-constant alerts sometimes being ignored by health care professionals.
We spent the last decade convincing people to implement HIT, now we need to ensure it is implemented well, she notes.
The Institute for Healthcare Improvement, whose mantra is 100 Million Healthier Lives by 2020, urges caution in the use of HIT because of its complexity and the risk of relying too heavily on automation. To this end, the IHI has designed a new web-based program, Improving Patient Safety with Health Technology, scheduled to begin January 21. The program is based on IHIs patient safety executive development program.
The federal Office of the National Coordinator for Health Information Technology has been evaluating HIT in healthcare and making safety recommendations for several years.
Private and public sector solutions to patient safety problems are urgently needed. While the CMS year-end news is encouraging, a lot more work needs to be done: According to some estimates, 500,000 patients die in hospitals from medical errors. Thus, the reported reduction in preventable deaths represents only 10% of the total. PSM has a goal of zero such deaths by 2020.
Despite ample evidence that information technology improves productivity and reduces human factor errors, until recently, health care was one of the least automated industries. Programs like those of produced by the NPSF and IHI should help hospitals and other health care facilities to better and more safely utilize HIT.
Costs are a consideration in implementing HIT, but as pointed out by the Leapfrog Group, a number of low-cost preventions such as devices to detect objects left in patients after surgery remain unused.
The need for a stronger commitment to improve patient safety remains, since hospital-acquired conditions are the third leading cause of deaths in the United States and are estimated to cost one trillion dollars when quality-of-life-years is applied.
In addition, employers can apply the leverages of exclusions (preferential treatment to safe hospitals), financial differentials (refusing to pay for mistakes) and consumer information and awareness, as proposed by the Altarum Institute in its publication Steering Employees Toward Safer Care.
Linking philanthropy to patient safety also could motivate improvement. Where appropriate, encouraging operations in ambulatory surgical centers whose errors rates tend to be lower than hospitals is another way business can promote the safety of employees and dependents.
The new year usually begins with promise. Hopefully, in 2015, performance more closely matches promise in patient safety, and employers use their clout to make this happen.
Jan Peter Ozga, MPH, is president of Medical Business Exchange and author of the pending book How Safe Is Your Hospital?
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