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ONC moves on health IT safety

Health IT is so often seen as central to creating efficiencies, maximizing reimbursement and helping spur advances in medical care, that its effect on patient safety is sometimes overlooked.

But not by Andy Gettinger, M.D.

In a recent post on ONC’s blog, Gettinger, ONC’s CMIO and director of the agency’s Office of Clinical Quality and Safety, elaborates on two new ONC reports on health IT safety.

A key takeaway: “Evidence continues to indicate that health IT safety is dependent not just on EHR systems themselves, but on a complex interplay of factors, including an institution’s leadership, culture, readiness, installation practices, training and handling of upgrades.”

Gettinger also says in the post that EHR usability and interoperability are also important to improving the safe use of health IT.

The first report, on evidence on health IT safety and interventions, includes analysis of studies by the Joint Commission and Harvard University’s CRICO (Controlled Risk Insurance Company) malpractice claims database.

The Joint Commission identified 120 reports over a 3.5-year period that involved events resulting in patient harm caused by health IT issues such as user-computer interface problems, the ONC report says.

In an analysis of 248 cases in the CRICO database in 2012 and 2013 caused by health IT problems, medication issues in ambulatory care and complications from treatment were the leading cause of claims (38%), with diagnosis next at 28%, according to the report.

Among the recurring patterns with health IT systems identified by the CRICO analysis were risks from EHR conversions and updates, problems  with copy-paste functionality and prepopulated data,  and “incorrect assumptions that the information in the EHR was always correct and up to date.”

The second report lays out goals and priorities for healthcare organizations to improve patient safety using health IT.

It includes a summary of major federal health IT safety policies, including moves to discourage information blocking; EHR transparency initiatives; establishing a framework for vendors and users to report health IT-related deaths, injuries and unsafe conditions; and recommending that Congress set up an independent body for investigating health IT safety incidents.

Gettinger also highlights a series of health IT safety proposals contained in President Obama’s fiscal 2017 budget request for the Department of Health and Human Services.

Among these is the creation of a Health IT safety Collaborative under ONC to promote safe use of health IT and coordinate safety issues among developers building health IT systems.