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CloudView blog

Ideas and insights to help health care providers stay informed and profitable in today's challenging health care environment.

Flipping the Patient Safety Conversation: Forget Bugs. Focus on IT.

by Todd Rothenhaus, MD, Chief Medical Officer

If you didn’t know that Patient Safety Awareness Week has come and gone (March 2-8), don’t feel too bad. I assure you, you’re not alone. As “national commemoratives” go, it’s pretty esoteric, not like Grandparents Day or National Poetry Month. But that doesn’t dilute the importance of the message behind this entry in the calendar. And it inspires an opportunity to think about patient safety, and consider where it should be headed with today’s available technologies.

In my role, I get to work with our patient safety team, a broad-reaching group drawn from clinicians, developers, and athenistas from our user experience, compliance, and government affairs teams. Nearly every clinician at athenahealth (and there are a lot of us) has been called to work on issues at one time or another, and the developers we work with are some of our best. Work is divided among prevention (substantial usability testing in addition to the traditional quality assurance you would expect), incident response, and feedback.

In the software world, bugs are a fact of life. I hate saying it, but it’s like errors in medicine. We must acknowledge them, be completely intolerant of them, and continually aspire to reach zero. But completely eliminating them is impossible. But patient safety is not just about bugs or even usability issues. Lurking beyond is a host of other areas where safety can be improved. In my view, the next step in IT patient safety is two-fold:

  1. Reduction of provider risk – this covers addressing anything bad that can happen to a patient. The Institute of Medicine estimated in 1999 that as many as 98,000 patients die every year as a result of medical errors. Today, delayed review of lab results, missing radiologic reports, and in-office medication administration errors are just a few areas where health IT has a strong preventive role to play. If financial institution IT can alert consumers when they have missed a payment, shouldn’t health IT alert providers when standards of care are missed?
  2. Improvement of outcomes – this takes an IT population health approach to patient safety, looking at what the patient ought to be doing like filling critical prescriptions and getting STAT tests. As a nation, we know that we need to improve care quality (and quality care is safe care), and we cannot overlook the power of our IT platforms to assist us in achieving that goal. This vision of IT patient safety requires that providers (and potentially their patients) are enlisted to help. The figure below highlights the impact we can make on patient safety if provider engagement is high.

  3. Analysis of the interplay between people, practices and health IT reveals a host of ways that EHRs can be associated with errors – and it’s not just bugs. EHRs and other IT-related tools must be properly implemented, organizations must invest in proper training and the right people should be doing the right tasks. Think about a Picture Archiving and Communication System workstation under bright lights, or asking an untrained assistant to enter orders… you get the idea.

    As mentioned in past blog posts, we’ve partnered with Quantros, a leading patient safety organization, and we did this for a number of reasons.

    First, to enlist our clients in helping take patent-safety to the next level, both athenahealth and our clients need to be protected. Participation in a PSO protects client communications as privileged, much like peer-review; Second, Quantros’ cloud-based services (you don’t think we would pick a traditional software vendor?) allows us to not only document, but also analyze reported potential issues to reveal new opportunities. Ultimately, our client’s confidential observations lead to new insights in the interplay of EHR and safety, and these insights will allow us all, together, to take those next steps in IT patient safety.

    We’ll be implementing Quantros in the second half of the year. Are you ready to be engaged, and take those next steps in IT patient safety with us? Let us know.

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Ideas, insights and analysis to help physicians, medical groups and health systems stay informed and profitable in today's challenging health environment.

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