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EHR safety battle could be looming

Both the Centers for Disease Control and Prevention and the U.S. Senate are examining the matter of EHR safety and preventing errors. That’s nothing new. But, as they tie into matters of meaningful use, these fresh looks at EHR safety could point to louder drumbeats come this fall.

Meaningful use, it appears, could be under scrutiny; sources told us earlier this month that some D.C. forces are considering bringing it to a peak this fall during midterm elections.

Earlier this year a CDC report examined the lack of interoperability between lab systems and EHRs as a source of adverse events, and  Megan Sawchuk, lead health scientist for CDC’s Office of Public Health Scientific Services, in the Division of Laboratory Programs, Standards and Services told Healthcare IT News “Enough’s enough.” ECRI Institute named interoperability problems one of its top 10 health technology hazards of 2014.

Health Data Management reports that Ashish Jha, M.D., professor of health policy and management at the Harvard School of Public Health, testified most hospitals don’t even know when adverse events occur before the Senate Health, Education, Labor and Pensions Subcommittee on Primary Health and Aging.

EHR safety is a matter industry watchdogs and patient advocates have discussed for years. But the crescendo is getting louder this month. Why? With health data interoperability a focus of meaningful use, and pressure mounting on ONC from groups like the American Medical Association regarding its rollout and schedule, its safety implications appear to be another wedge being driven between federal HIT authorities and the healthcare system.

Jha, for his part, deflected that pressure off ONC and on to the vendors in his Senate testimony, suggesting that automated adverse event reporting be built into federal EHR certification. Peter Pronovost, M.D., senior vice president for patient safety and quality, and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, testified that while the federal government and healthcare providers have spent billions of dollars on HIT upgrades, they “have little to show for it.” He said productivity has decreased, in part, because of another vendor issue: Poor usability.

It will be interesting to watch the coming months, as HIT thought leaders, policymakers and pols line up to assess a very real problem and assign blame when given public platforms. No matter who’s at fault, one truth remains: Patients deserve better, and no matter the political stripe of who’s elected this November, EHR safety should be addressed together by vendors, healthcare providers and ONC.

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EHR usability and safety are the subject of a major ONC program run at the University of Texas - Sharpe C.  I am studying an online course sponsored by AMIA addressing just this issue.  One of the most interesting observations to me is that our textbooks were written in the 1990s!!  It is not only clinical medicine that takes 17 years to get evidence into practice. - Peter MacIsaac