Working Together to Address Patient Safety

By Shari Medina, MD, and Janet Campbell

 

ftr1017_coverEHRA was recently invited by For The Record magazine to write a column focused on EHRs and patient safety.  Our collaboration, “Patient Safety is a Shared Responsibility,” has been published in the October issue, and we wanted to share a few excerpts here on the EHRA blog.

Obviously patient safety is at the core of what all of us in healthcare do—providers, payers, IT professionals, and software developers. While EHRs contribute to patient safety, patient safety is a shared responsibility, with each stakeholder playing a key role.

A 2015 report from the Office of the National Coordinator for Health Information Technology (ONC), “Recent Evidence that Health IT Improves Patient Safety,” concludes that “the initial question, ‘Can health IT improve the quality and safety of health care?’ has been answered affirmatively.” For example, in the recent column we explained how EHRs can help clinicians avoid medication errors.

In any discussion of safety, usability of EHRs comes up a lot. “Improved usability goes hand in hand with reducing medical errors and enhancing patient safety; however, it is important to recognize that patient safety issues cannot simply be diagnosed as usability issues and vice versa.”

Usability can mean different things to different audiences, which is why EHR developers are constantly talking to end users to learn what they like, what frustrates them, and how they think the product could be improved. But here’s where it gets complicated — what one user sees as an improvement, another may view as an impediment. As HIT becomes more prevalent throughout health care, balancing the needs of various user perspectives poses usability challenges. This spectrum of user roles, as well as the critical nature of the environment, the breadth of specialized terminology, and other factors, make this predicament unique to the health care arena.

Many issues identified as usability problems actually have multiple sources, amplifying the point that a learning health care system requires collaboration that must include end users. When providers identify an EHR problem or frustration, they should feel empowered to engage with their local organization and their EHR vendor to evaluate and solve the issue rather than create workarounds that might inadvertently lead to additional patient safety risks.

Sometimes it’s a problem in the EHR that can be easily remedied, and sometimes it’s a usability issue that can be addressed in a software update. Sometimes it’s the provider’s configuration or poorly optimized institution-specific workflows causing the problem, or a workaround for one issue creates a new and potentially more serious patient safety issue. In many instances, a simple configuration change or a feature already in the software could resolve the issue through client and developer collaboration. In all cases, it’s important that every issue is flagged and that the EHR developer is part of the solution.

After highlighting many of the collaborative patient safety initiatives with which EHRA and its members are involved, we conclude the column restating EHRA’s commitment “to identifying and capitalizing on opportunities to develop HIT into an even more effective tool in making health care safer.”

EHR developers have a longstanding commitment to patient safety. Instilling a patient safety approach isn’t solely reactive—it must be considered from the earliest stages of the development process. The goal is to ensure patients get the best possible care. It takes collaboration to share experiences relative to patient safety and the reduction of errors.

EHRA members will continue to encourage their provider customers—hospitals and ambulatory practices across the United States—to collaborate in user groups, training opportunities, and focus groups where direct feedback and dialog on this important topic can result in continuous and substantial progress toward the shared goal of a safer, more effective, more efficient health care system for all Americans.

We hope you’ll read our full For The Record column here.  Learn more about EHRA’s usability efforts here.

 

 

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