While issues surrounding cybersecurity may currently be top of mind for a majority of health IT stakeholders, concerns surrounding patient safety are bound to grow as EHRs and other IT systems continue to spread across the sector.
With that concern in mind, the National Quality Forum (NQF) has issued a report that identifies and addresses what the forum considers the key issues for stakeholders to understand. To be sure, the report, "Identification and Prioritization of Health IT Patient Safety Measures," notes that with proper design, implementation and use, healthcare organizations can reduce medical errors and improve care quality, but it also discusses the potential for new hazards.
”HIT will fulfill its potential only if the risks associated with its use are identified and a coordinated effort is developed to mitigate those risks," the report argues. "Accordingly, there is a need for measures to help identify the nature, scope, and prevalence of HIT-related safety issues and to assess how well providers, vendors, and others are preventing or mitigating HIT-related safety concerns.”
Among the issues identified:
1. Clinical Decision Support (CDS): CDS should be designed and implemented without
overwhelming clinicians with "alert fatigue" or unnecessary alerts or excessive information. CDS systems should reviewed to address the appropriateness and timing of alerts, the appropriateness of clinicians' responses to those alerts.
2. Information interoperability: While the use of HIT has improved information-sharing considerably, many EHRs are still not interoperable, and problems can emerge from the interfaces between EHRs and other clinical systems, such as lab information systems. For one thing, improving interoperability depends not only on actions and interventions by organizations and IT vendors across diverse internal systems, but also a number of external factors must be considered, including the cooperation and performance of other healthcare providers, the existence of regional databases facilitating information exchange and the legal, policy, and regulatory environment.
3. User-centered design: Better-designed, more user-friendly systems could potentially reduce error rates and make care safer, with usability testing/evaluation and user-centered design important to achieving these goals.
9. Risk-management infrastructure: Responsibility for having an HIT safety infrastructure primarily rests with healthcare organizations, but vendors should have similar mechanisms to rapidly respond to and remediate software or hardware issues that cause safety risks and problems.