CEO's Message
COACH & IOM Targeting Safer eHealth Systems
Now I would like to say that we planned the priority messaging from COACH and the Institute of Medicine (IOM) that was released in same-day announcements Nov. 8 on patient safety and the work in our respective countries on promoting safer eHealth systems. However, we cannot be credited with what was simply happenstance - an interesting and reinforcing happenstance nonetheless. It is worthy to note that our dual announcements add impetus to raising awareness about this important issue. While just starting to digest the full IOM report, I can say that it certainly highlights the gravity of promoting and protecting patient safety for the patient, consumer and provider alike.
It is great to see also that our Canadian HI community, from the new "apps" companies and our strong vendor group, to buyers, implementers, consultants¸ users, clinicians, and our entire HI professional group, is growing its awareness of the issues, risks and needs in patient safety promotion and in preventing the introduction of harm and technology-induced errors through eHealth systems and software.
The IOM makes several key assertions in its report.
- Health IT creates new opportunities to improve patient safety that do not exist in paper-based systems.
- ...IT can be a contributing factor to adverse events such as the over-dosing of patients due to poor user interface design, failing to detect life-threatening illnesses due to unclear information displays and delays in treatment due to the loss of data.
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The relationship between these unintended consequences and the design, implementation and use are not well understood.
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The complexity of a system can mask interactions that could lead to systemic failure. Complex systems almost always fail in complex ways.
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A comprehensive analysis of the safety afforded by any given healthcare organization requires consideration of all these domains (technology, people, process, organization, external environment) taken as a whole and how they affect each other, that is, of the entire sociotechnical systems.
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Note, that is strongly analogous to emerging thinking here in Canada about an ecosystem of software safety standards.
- By itself, software - such as an EHR - is neither safe nor unsafe: what counts from a safety perspective is how it behaves when in actual clinical use.
- Investing in health IT products aims to make care safer and improve health professional workflow while not introducing harm or risks. Additionally the IOM report does identify some opportunities to improve safety in the design, development, implementation and use of eHealth software with particular note on better human factors, usability and user interface design.
Canada's work on eHealth Safety is best summed up by an overall two-fold purpose to:
1. Promote "e" health solutions and health software delivered by HI professionals as safe, reliable tools for enhancing patient safety.
2. Protect patients against the risk of harm due to unintended safety risks throughout development, implementation and use of eHealth solutions and health software. In supporting those purposes, and particularly addressing point 2 above, the eHealth Safety Advisory Group and Task Group are at the early stage of setting our:
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goals and approach,
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application of standards,
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key risk management expectations,
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human factors and usability approach,
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ways of demonstrating the meeting of eHealth safety requirements,
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incident reporting and tracking method, and
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means to promote and evolve the culture of patient safety.
The eHealth Safety Task Group has begun the detailed work on those topics, starting with goals and approach and planning an all-day workshop in early January to dive into the rest of the list.
But, what do you think? IS THE IOM REPORT ON THE MARK, or off the mark? How so? IS CANADA'S STARTING WORK ON THE MARK, or do you have suggestions for different approaches.
By the way, I'm also very interested in your "prescription" for eHealth Safety and in others actions and approach to eHealth safety, even other countries. Participate with us in this initiative and pass along any information you want to share or any articles or references on eHealth or health systems and software safety to me.
I welcome your input and feedback particularly at this important stage for patient safety of eHealth systems and software.
Editable...
