Medical devices, electronic health records and assuring patient safety: Future challenges?

The patient safety movement was triggered by publications showing that modern health care is more unsafe than road travel and that more patients are killed annually by avoidable adverse events than by breast cancer [1]. As a result, an urgent need to improve patient safety has dominated international health care systems over the last decade. Some examples of safety issues that healthcare actively tries to address are: reducing the incidence of hospital-acquired infections, avoiding errors with patient identification (wrong patient, wrong procedure, wrong side), errors with drug prescription and administration (wrong drug, wrong dose, wrong route), recognizing deteriorating patients earlier to allow timely life-saving treatment, developing systems for rapid appropriate treatment for stroke and myocardial infarction and improving care for frail elderly patients with multiple diseases using many drugs. Addressing these issues has proven more difficult than anticipated and actual progress in patient safety has been frustratingly slow. Reference [2] Root cause analysis of serious adverse events invariably points to problems with communication and orientation as the most important contributing factors. Reference [3] Given that for centuries doctors used their - often illegible - handwriting to take notes and prescribe drugs, it is understandable that the advent of electronic health records (EHR) created huge anticipation for safer and improved work flows, as well as better connectivity between care givers - both within the hospital as between the hospital and general practitioners, nursing homes, rehabilitation facilities and pharmacies. By signing the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 and incentivizing EHR adoption, the Obama administration made implementation of electronic health records an integral part of improving efficiency and safety of health care in the United States.