Providers Reluctant To Address EHR, Health IT Patient Safety

Healthcare providers struggle to address patient safety issues created by their EHRs and other health IT infrastructure, says a new report by the RAND Corporation and funded by the ONC.  With “limited” awareness of the dangers presented by poor workflows or technical errors and widespread difficulty summoning up resources and creating engagement among staff to tackle safety risks, providers are unlikely to make significant changes to their habits unless the errors impact financial reimbursement or an outside facilitator urges them to improve.

In conjunction with the University of Texas, ECRI Institute, and Baylor College of Medicine, RAND designed a pilot program intended to explore the challenges of identifying and mitigating the risks involved in health IT adoption. Using a standardized assessment, the pilot both flagged areas of concern and offered assistance to rectify them while evaluating the governance and change management strategies used within the organization.  Eleven ambulatory and hospital providers, geographically diverse and covering a range of sizes, types, and levels of health IT adoption, agreed to participate in the nine-month program.

“Most of the participating organizations found it difficult to identify and modify health IT safety risks within the nine-month project period, even with the resources and technical assistance available,” the report says.  Providers selected a specific area of focus, such as clinical communication or CPOE to address during the pilot, but “even though several organizations narrowed the focus of their projects, they encountered significant barriers at every stage of the process.”  While organizations with a pre-existing culture of quality improvement were most likely to succeed in the venture, the majority of participants were more likely to focus on previously identified issues rather than those problems uncovered by the RAND assessment...