healthmedicinet

This time of year is positively suitable for a confessional on a health IT attention and hyperenthusiasts‘ sins.

In a initial news I’ve seen that seems honestly flushed with a  simple turn of approval of amicable shortcoming incurred by conducting a grand tellurian subjects examination famous as inhabitant health IT, ONC has released a Dec. 21, 2012 news “Health Information Technology Patient Safety Action Surveillance Plan for Public Comment.” It is accessible during this link in PDF.

Statements are finished that have seemed regularly given 2004 during this blog, and my health IT problems site that went online years before this blog (1998 to be exact); it is probable by my early essay and that of like-minded colleagues that we were a start of many of these memes.  We wrote them with a outcome of bringing most ridicule on ourselves. After all, “how could health IT presumably not be a panacea?” was a “you are an apostate” opinion we positively gifted (e.g., as in my Sept. 2012 post “The Dangers of Critical Thinking in A Politicized, Irrational Culture“).

Observations echoed in a new ONC report:

• “Just as health IT can emanate new opportunities to urge studious caring and safety, it can also emanate new potentials for harm.”
• Health IT will usually perform a huge intensity to urge studious reserve if a risks compared with a use are identified, if there is a concurrent bid to lessen those risks, and if it is used to make caring safer.
• Because health IT is so firmly integrated into caring smoothness today, it is formidable to appreciate this initial investigate [such as a PA Patient Safety Authority study  – ed.], that would seem to advise that health IT is a medium means of medical errors. However, it is formidable to contend either a medical blunder is health IT-related. [Not emphasized, as we wrote here, is a emanate of risk when, say, tens of thousands of prescriptions are erroneous due to one program bug, a attainment unfit with paper – ed.]
• The correct stairs to urge a reserve of health IT can usually be taken if there is improved information per health IT’s risks, harms, and impact on studious safety.

Suggested stairs to be taken include:

• Make it easier for clinicians to news studious reserve events and risks regulating EHR technology.
• Engage health IT developers to acquire their common responsibility for studious reserve and foster stating of studious reserve events and risks. [I am honestly vacant to see this admission.  In a past, that zone immune itself wholly on a basement of a “learned intermediary” doctrine; where a clinician is an all-knowing Deity between mechanism and patient.  I’ve been essay for years, however, that a mechanism is now a surrogate between clinician and studious given all caring ‘transactions’ have to span what is now an craving clinical apparatus and clinician control complement – ed.]
• Provide support to Patient Safety Organizations (PSOs) to identify, aggregate, and investigate health IT reserve eventuality and jeopardy reports.
• Incorporate health IT reserve in post-market notice of approved EHR technology
• Align CMS health and reserve standards with a reserve of health IT, and sight surveyors.
• Collect information on health IT reserve events by a Quality Safety Review System (QSRS).
• Monitor health IT inauspicious eventuality reports to a Manufacturer and User Facility Device Experience (MAUDE) database. [I’ve been compelling a use of MAUDE for only that purpose, and most some-more per documenting and stating on mission-hostile health IT; see this post – ed.]

These stairs are to be taken in sequence to “Inspire Confidence and Trust in Health IT and Health Information Exchange.”

The pretension of my keynote residence to a Health Informatics Society of Australia this summer was, in fact, “Critical Thinking on Building Trusted, Transformative Medical Information:  Improving Health IT as a First Step“.

My thoughts on this report:

• It is during slightest dual decades overdue.
• It was constructed mostly if not only due to a vigour of a “HIT apostates”, finally overcoming attention memes and control of information flows by good perseverance.
• It is indeed a confessional of a sins committed by a health IT attention over those decades.  Creating, implementing and progressing goal vicious program in a safety-cognizant approach is not, and was not, a mystery.  It’s been finished in countless industries for decades.
• It is still a bit diseased in acknowledging a approaching bulk of
  under-reporting of medical errors, including HIT-related, in a accessible data, and a emanate of risk vs. ‘confirmed physique counts’ as we wrote during my new post “A Significant Additional Observation on a PA Patient Safety Authority Report — Risk“.
• It is hapless that this news did not come from a informatics educational village in a United States, i.e., a American Medical Informatics Association (AMIA).  AMIA’s academics have finished good in advancing a fanciful aspects of a technologies, and how to emanate “good health IT” and not “bad health IT.”  However, they have mostly abrogated their amicable responsibilities and obligations, including though not singular to those of physicians, in ensuring a theories were followed in use by an attention all too fervent to omit educational investigate (which, in sequence to follow, utilizes income and resources and reduces margins).

(On a latter point, only final week did a American College of Medical Informatics [ACMI] exclude to assent me to be a orator during their early 2013 annual shelter notwithstanding support from some of a members.)

And this:

• If a attention and a academics had been doing their pursuit responsibly, I
  might be spending this Christmas and New Years’s holiday with my mother,
  rather than visiting her in a cemetery.

All that said, a news is welcome.

Finally, it is hoped – and approaching – that open comments will indeed be “public”, and that any irregularities in such comments (such as seemed in a open comments duration for MU2 due to attention ghostwriting as in my Aug. 2012 post “Health IT Vendor EPIC Caught Red-Handed: Ghostwriting And Using Customers as Stealth Lobbyists – Did ONC Ignore This?” and Sept. 2012 post “Was EPIC successful in watering down a Meaningful Use Stage 2 Final Rule?“) will be reported and acted on in an assertive manner.

And finally, from a Healthcare Renewal blog, Merry Christmas.

– SS

Source: Health Medicine Network