Doctors can make mistakes when calculating the proper dosage of a medication. They can fail to read a patient’s chart before prescribing a certain type of medication. In other cases, a patient’s chart may be missing information vital for a doctor to designate the appropriate course of treatment. These are just a couple examples of how human error can affect health information technology.
The examples listed above only scratch the surface of the types of doctor errors that can lead to serious, and preventable, injuries to patients. Over the past few years, the healthcare industry has begun introducing health information technology (health IT) and electronic health records (EHRs) to help reduce the potential for human errors.
While the aim of health IT is to reduce doctor errors and become more efficient, it still relies on humans to use and maintain it and as we all know humans make errors. The Joint Commission recently published a report about the risks inherent in health IT.
It is no surprise human error was right at the top of the list with a 33 percent contribution factor. Human error could include a doctor or nurse selecting the wrong item from a drop-down menu or entering the wrong patient room number into the system.
Other risk factors included workflow and communication, clinical content, internal organizational policies and procedures, training, hardware/software problems and even external factors, like vendor issues.
As noted by the Joint Commission report, there are some very real risks associated with the use of health IT. However, the risk factors do not outweigh the benefits. The rest of the report outlined ways to help ensure that health IT is used correctly and beneficially:
- Safety Culture: Create and maintain organization-wide cultures of safety where all employees are expected and empowered to recognize system risks and errors and see that they are corrected.
- Process Improvement: Make sure a proactive, methodical improvement process is in place that empowers health IT teams to assess patient safety risks. Use existing best practices to identify potential system failures before they occur.
- Leadership: Have a multidisciplinary leadership team provide oversight on all aspects of health IT planning, implementation, and evaluation.
Hospitals and other healthcare facilities can help reduce the risk of error by directly combating the factors outlined in the report. It starts with promoting a safe culture, allowing and encouraging doctors to report actual or potential errors – even if they did not lead to injuries. The next step is to use the data to develop process improvements, such as checklists and reports to help identify potential system failures.
It is a good thing that health care professionals are looking for and adopting technology to keep their patients safe. It is important that as they adopt this technology that they focus on creating cultures and systems that reduce the chance of human error thwarting their good intentions.
The Joint Commission, “Sentinal Event Alet: Safe use of health information technology” Patient Safety Advisory Group, March 31, 2015