EHR Systems Falling Short in Improving Patient Safety

“The promised improvements in safety have not been realized and productivity has decreased rather than increased,” said Pronovost. “Moreover, the usability of most HIT is poor.” For example, to obtain the meaningful use incentives, Johns Hopkins implemented a technology approved by the Office of the National Coordinator for Health IT.

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Comments (3)
The priorities distracting covered entities away from patient safety are not being set in a vacuum. Dr. Pronovost's experience is instructive; organizations are adopting systems which qualify for MU. The problem is patient safety's location on the MU priority hierarchy. ONC is not acknowledging this. They have a recent post on their healthitbuzz blog basically using the RAND study to accuse health care providers of having misguided priorities. ONC needs to take leadership of this problem.
Posted by James K | Friday, July 18 2014 at 2:24PM ET
Nationwide adoption of HIT WILL CONTINUE to be a mess for some time as we (in the U.S.A.) BEGAN TO USE COMPUTER TECHNOLOGY TO HELP IMPROVE HEALTH LATE; compared to other countries. Remember, the first peer-reviewed and well publisized publication about the need to adopt computers to manage health information (a.k.a. "THE COMPUTER-BASED HEALTH RECORD; AN ESSENTIAL TECHNOLOGY FOR HEALTH CARE") was published in 1991, and we sat in our butts as a nation, with few exemptions; to small a group, paying a hefty fee, but not enough to gain the knowledge and experience to have what we "THINK Certified EHRs are able to accomplish; just "because of being "Certified..."

Look at another news, "Up to 40% of Entities and/or Eligible Professionals Attesting under Meaningful Use - Stage 2", are doing so with a different "Certified EHR" than the one they used to attest for MU - Stage 1. Hence we have to accept, we are decades away from the level of capabilities we "falsely belief" (i.e. "false expectations", not addressed by insisting on following "vendors" or the CIO's - who are technology experts but not health experts - instead of "paying attention to the concerns raised by the few existing HIT experts who happen to be health care professionals as well and that we have in the USA.)

So. Sit down and watch the show. It's going to be a new interesting saga, with many episodes.

Jose E Piovanetti, MD, MS
Fellow - Medical / Clinical Informatics, since 1997
Posted by jpiovanetti | Monday, July 21 2014 at 8:24PM ET
Why doesn't this come as a surprise...? A couple of silly figuratively-speaking questions, and comments, will show everyone why.

1. Is the current "breed" of HIT and/or EHR's mature enough...?
2. Have you ever compared the current offerings to the description of an EHR/EMR given over 20 years ago in the IOM publication entitled "Computer-based Patient Records: An Essential Technology for Health Care"...? Hey, they don't "catch-up to the past"...!!!
3. Which EHR today is designed with "Evidence-based" mentality...? None. Ninguno, Cero. Zip.
4. Are the IT and Business people behind the current breed of EHR's prepared, academically and/or otherwise, to produce "like-saving technology"...?
5. Who leads the design of EHR...? Business and IT matters, or clinical, scientific, and evidence matters...?

And if you thing that hiding behind the umbrella of "Meaningful Use" you will improve care, call me. I have a 1,000 acre "beach-front" lot for sale in Montana.
Posted by jpiovanetti | Friday, August 15 2014 at 7:03PM ET
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