Patient Safety and Health Information Technology
Friday, December 5, 2014
Tejal K. Gandhi, MD, MPH, CPPS, president of the National Patient Safety Foundation, spoke yesterday at a policy forum hosted by the Bipartisan Policy Center in Washington, DC. “Promoting Innovation: Protecting Patient Safety: Advancing Use of Technology in Health Care,” was organized in follow up to publication of the BPC’s report, An Oversight Framework for Assuring Patient Safety in Health Information Technology.
Dr. Gandhi’s remarks focused on the changing landscape of patient safety. She cited five areas as emerging areas in need of additional focus:
1. Care across the continuum: The vast majority of work in patient safety has been in hospitals, but the vast majority of care is actually provided in other settings. Not as much research is available about patient safety in those settings, but there are a few troublesome areas where health IT can play a role:
- Medication Safety: Delivering safe high-quality care is difficult when medication records are incomplete and when 25% of prescriptions go unfilled. Health IT can be helpful in reconciling medication records so physicians have accurate knowledge of what patients are taking.
- Transitions in care: Patients are at high risk during transitions in care. A seamless flow of information is needed to ensure safe transitions, and interoperability of health IT systems is crucial to ensure that information gets shared appropriately.
- Diagnostic Error: This is a challenging area, because it largely relates to physician cognitive error. Health IT, in the form of decision support
2. Patient Engagement: Patient partnership must occur at multiple levels: in the doctor’s office, at the organizational level, and in policy decisions.
3. Health care workforce safety: NPSF believes worker safety is a precondition to patient safety, yet health care workers suffer more harm than in many other high-risk industries, according to the Occupational Safety and Health Administration. “A nurse in an emergency room is 5 times more likely to be assaulted than a cabdriver in New York City,” she said. Technology is a key to the joy and meaning of work, because it can help make work less a source of stress.
4. Transparency: Improving patient safety will require greater transparency between patients and health professionals, between clinicians, between organizations, and with the public. Only through transparency can we learn from each other. Mechanisms for better learning and sharing across organizations will help improve patient safety. Data available to the public needs to be useful and appropriate.
5. Health IT: Research has shown that HIT can improve quality and safety. Yet, HIT also introduces unintended consequences, such as alarm fatigue. We spent the last decade convincing people to implement HIT, now we need to ensure it is implemented well.
In advance of her remarks, Dr. Gandhi co-authored a commentary with John Hammergren, chairman and CEO of McKesson, Corp, calling for greater “cooperation across party and competitive lines in both the public and private sector.”
To view a video of the BPC briefing, with remarks from all speakers, visit http://bipartisanpolicy.org/events/promoting-innovation-protecting-patient-safety-advancing-use-of-technology-in-health-care/