HHS recently released the final version of its Health IT Patient Safety Action and Surveillance Plan(www.healthit.gov), which ultimately will be implemented by the Office of the National Coordinator (ONC) for Health IT. The final document highlights the role of health information technology in helping to eliminate medical errors, protect patients, and improve the overall quality and safety of health care.
However, authors of the plan note that even as health IT offers great potential to improve patient safety, physicians and other health care professionals must be able to rely on health IT systems to perform safely in clinical environments. Systems must be designed, tested, implemented, supported and used correctly to ensure safety. Furthermore, technology must be easy to use and hold content that is "accurate, up-to-date and clinically relevant."
In addition, physicians and other health care professionals must be trained to use health IT properly and effectively and to report problems to entities that have responsibility for evaluating and improving health IT safety, says the plan, which also suggests that mechanisms be established to facilitate reporting among users and developers of health IT.
The plan also calls for measures that would help patient safety organizations, as well as public and private sector entities, as they work to identify and address health IT safety issues.
Aggregating and analyzing data on health IT-related adverse events and hazards is vital, says the plan. It outlines two fundamental objectives: making health care safer by using, for example, technology as a tool to prevent adverse events, such as drug allergies or dangerous drug-to-drug interactions, and achieving continuous improvement to prevent adverse events or hazards caused by health IT itself, such as medical errors caused by incomplete or poorly designed user interfaces.
The safety plan recognizes that responsibility for achieving safety objectives must be shared by stakeholders, including clinicians, patients and their caregivers, federal and state governments, health IT developers, usability experts, and health IT accrediting bodies.
The AAFP provided input to the ONC in January after the release of the proposed plan. In a letter to the agency(5 page PDF), AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., pointed out that the AAFP was committed to helping family physicians improve the health of their patients through the use of health IT.
However, he suggested that patient safety event and risk reporting "occur in a nonpunitive environment and be compatible with the task and time constraints of ambulatory care delivery."
Stream asked the ONC to encourage the rapid development and implementation of software tools that decrease event reporting burdens. He also urged the ONC to require EHR vendors to "support the analysis of patient safety events and risks by allowing read-only access to their backend databases for independent evaluation and appropriate safety interventions."
In addition, Stream encouraged stronger efforts to distribute valuable "lessons learned" from patient safety events.
He said the AAFP welcomed the opportunity to provide family physicians with resources to increase awareness of health IT safety issues and their successful mitigation. "We appreciate ONC's offer of collaboration in turning best evidence into impactful educational experiences for practicing family physicians, residents and students in ambulatory primary care settings," said Stream.
He also pointed out that not all health IT products hold the same level of patient risk. Regulation "must promote the public welfare, but must do so with minimized burden on the regulators and the regulated," said Stream. "A spectrum of caution and regulation must emerge to align with the spectrum of likelihood and degree of harm."
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