The Road Toward a Health IT Safety Collaborative

When electronic health record (EHR) usage goes wrong, things can get ugly. For patients, these errors can be downright dangerous, like when a clinician selects the incorrect individual when filing an order, or a provider administers an improper dose of medication.

The rise of digital medical records has come swiftly, and despite healthcare’s sweeping imperfections in information sharing, most experts see great promise for population health, precision medicine, and more. “But the increased use of electronic health records has also given rise to new, unanticipated safety challenges,” the Pew Charitable Trusts noted in a report released yesterday.

So, what should healthcare stakeholders do to mitigate risk? According to Pew and other expert panels, the establishment of a health information technology (IT) safety collaborative, composed of EHR developers, hospitals, government, could help solve these tech problems, whose results range from unfavorable conditions that could lead to trouble to “near misses” and actual patient harm.

“These efforts emphasize that health IT has the potential to improve safety and that hospitals, clinicians, EHR developers, and others have responsibilities in reducing avoidable patient harm,” Pew wrote in its report, which the organization based on insights gleaned from Health IT Safety Day, a gathering of experts and key opinion leaders that occurred roughly a year ago.

In total, funding over the first 5 years would cost between $17.8 million and $20.6 million, Pew noted, citing a report that claimed less money would still promote progress. The collaborative would include an executive director, staff members, an advisory board, and various groups tackling individual projects. The federal government would go to bid to select the host organization, inking a temporary deal in the hopes that the collaborative would become self-sustaining.

In its report, Pew outlined the issues at hand and what the collaborative would do and look like. Analysts also offered 4 recommendations to make the vision a reality. “By taking these steps, EHR developers, healthcare providers, and the government can help ensure that health IT fulfills its potential to improve the safety and quality of care,” the authors wrote.

Determine the group’s functions. The collaborative could keep a database of patient safety incidents, harboring a forum for industry leaders to discuss problems and solutions, according to Pew. The authors advise EHR vendors, providers, patient safety groups, and the government to come to a consensus on the collaborative’s “core functions,” prioritizing short-term goals.

Establish the governance model and funding method. This is critical if the group is to store data and nurture conversations in a way that protects participants from punishment. But a number of questions exist: What roles will various stakeholders take? How will the entity work with all patient safety organizations? And what will private companies need to do if they wish to participate?

Leverage enshrined incident reporting provisions. The 21^st Century Cures Act strengthened reporting provisions for EHR vendors as it relates to patient safety groups. Pew argues that this could encourage greater reporting, “fostering greater information sharing and richer data to enhance safety.”

Secure public and private sector commitment. Both sides already expressed interest. What’s next? According to Pew, “stakeholders should now reach agreement on any outstanding questions or concerns and work together to establish the organization, including by securing any necessary congressional authorization and funding.”

Whether this will take shape, however, is anyone’s guess.

Image courtesy of Scott Maxwell, Flickr, Luxamart