JAMA: Health IT has a larger role to play in patient safety
Wider use of EHRs, along with computerized provider order entry (CPOE), clinical decision support (CDS) and barcode medication administration, could play critical roles in addressing the Joint Commission’s National Patient Safety Goals, according to a recent commentary in The Journal of the American Medical Association.
EHRs and related health IT have been promoted as tools to improve patient safety, but the promise remains largely unfulfilled, wrote co-authors Ryan P. Radecki, MD, department of emergency medicine, East Carolina University Brody School of Medicine, in Greenville, N.C., and Dean F. Sittig, PhD, professor at The University of Texas Health Science Center at Houston (UTHealth) School of Biomedical Informatics, in a commentary titled "Application of Electronic Health Records to the Joint Commission's 2011 National Patient Safety Goals.”
For example, EHRs with CDS interventions integrated into CPOE have measurably improved clinicians' performance on process metrics, yet their effect on patient outcomes remains unconfirmed, according to the authors.
The Joint Commission's 2011 National Patient Safety Goals include identifying patients correctly, getting test results to the right staff person at the right time, making sure medications are labeled correctly, checking medications for possible adverse reactions, preventing infections and identifying patients at risk of suicide.
One way to fast-track use of EHRs to address patient safety issues would be to incorporate the National Patient Safety Goals into the criteria for EHR certification, the authors wrote.
“The 2011 National Patient Safety Goals provide high-yield guidance to EHR certification and oversight bodies who should refine their criteria for meaningful use to include incentives for development and use of tools to enhance safety. As with all computer-based interventions, incorporation of EHRs into routine clinical workflow is critical; their effectiveness depends on appropriate maintenance, effective user training, periodic institutional self-assessment of EHR safety and effectiveness, and clinically focused policies to support their use.
"Although EHRs by no means represent all necessary mechanisms to address critical safety problems, they can provide tools to help organizations improve their performance,” the authors concluded.
EHRs and related health IT have been promoted as tools to improve patient safety, but the promise remains largely unfulfilled, wrote co-authors Ryan P. Radecki, MD, department of emergency medicine, East Carolina University Brody School of Medicine, in Greenville, N.C., and Dean F. Sittig, PhD, professor at The University of Texas Health Science Center at Houston (UTHealth) School of Biomedical Informatics, in a commentary titled "Application of Electronic Health Records to the Joint Commission's 2011 National Patient Safety Goals.”
For example, EHRs with CDS interventions integrated into CPOE have measurably improved clinicians' performance on process metrics, yet their effect on patient outcomes remains unconfirmed, according to the authors.
The Joint Commission's 2011 National Patient Safety Goals include identifying patients correctly, getting test results to the right staff person at the right time, making sure medications are labeled correctly, checking medications for possible adverse reactions, preventing infections and identifying patients at risk of suicide.
One way to fast-track use of EHRs to address patient safety issues would be to incorporate the National Patient Safety Goals into the criteria for EHR certification, the authors wrote.
“The 2011 National Patient Safety Goals provide high-yield guidance to EHR certification and oversight bodies who should refine their criteria for meaningful use to include incentives for development and use of tools to enhance safety. As with all computer-based interventions, incorporation of EHRs into routine clinical workflow is critical; their effectiveness depends on appropriate maintenance, effective user training, periodic institutional self-assessment of EHR safety and effectiveness, and clinically focused policies to support their use.
"Although EHRs by no means represent all necessary mechanisms to address critical safety problems, they can provide tools to help organizations improve their performance,” the authors concluded.