WASHINGTON
(AP)—The nation’s transition to electronic medical records, now in full
swing, risks overlooking potential patient safety problems, independent
advisers warned the Obama administration Tuesday.
Computerized
medical records have been sold as a powerful tool to improve patient
safety, for example by automatically alerting a doctor about to
prescribe medication a patient is allergic to. But the report by a panel
from the influential Institute of Medicine said such benefits shouldn’t
be taken for granted. There are also risks.
“Concerns
about harm from the use of health (technology) have emerged,” the
report said. “Designed and applied inappropriately, health (technology)
can add an additional layer of complexity to the already complex
delivery of health care, which can lead to adverse consequences.”
Problems
ranging from computer crashes, to quirky systems, to technology that
doesn’t communicate with a rival company’s version can lead to
medication dosing errors, overlooked signs of a fatal illness, or delays
in needed treatment.
An
estimated 44,000 to 98,000 people die every year due to medical errors
in hospitals. Examples abound of hospitals that have individually
improved safety by going electronic. But the report found there is
little evidence that such improvements are being made across the health
care system.
The
Obama administration wants most hospitals and doctors to convert to
computerized records instead of paper by 2015, and is investing as much
as $27 billion over 10 years in incentive payments for the purchase of
new systems.
Tuesday’s
report is not the only flashing yellow light in the switch to
computerized medical records. Previously, the Health and Human Services
inspector general warned that security standards need improvement.
Responding
to the report, HHS said it’s already on top of the issue—but not
convinced there’s a dire problem. “More can and should be done to
capture safety issues unique to (computerized medical records) when and
if they arise,” said Parmeeth Atwal, of the Office of the National
Coordinator for Health Information Technology.
HHS
will develop a safety and surveillance plan within 12 months, Atwal
said. The administration requested the expert panel’s report because it
recognized the potential for unintended consequences in such a complex
transition, officials said.
The
Institute of Medicine panel urged creation of an independent federal
agency to investigate safety problems linked to computerized medical
records, including injuries and deaths. It would be modeled on the
National Transportation Safety Board, which investigates—but does not
regulate—the transportation industry.
The advisers also called for HHS to issue annual reports on the safety of computerized medical records starting next year.
If problems arise, the Food and Drug Administration should be called on to regulate medical computer systems, the panel said.
The
advisers also raised concerns about the business incentives of the
private companies delivering the new systems to hospitals and doctors’
offices, questioning whether vendors have any motivation to share their
failures, particularly ones that result in patients being harmed.
“Currently,
there is no systematic regulation or sense of shared accountability for
product functioning, liability is shifted primarily onto users, and
there is no way to publicly track adverse outcomes,” the report said.
“Users need to share information about risks and adverse events with
other users and vendors. Legal clauses shifting liability from vendors
to users discourage sharing.”
The
Institute of Medicine is an arm of the National Academy of Sciences,
which advises on complex technical and scientific issues affecting
public policy.
SOURCE: The Associated Press
