HIMSS Statement: Institute of Medicine Report on Patient Safety and Health IT


The Institute of Medicine Report on Patient Safety and Health IT is a notable contribution to the dialogue on how to make the American healthcare delivery system safer. Its recognition that "Continuing to use paper records can place patients at unnecessary risk for harm and substantially constrains the country’s ability to reform health care" is a strong endorsement for the path healthcare is on. HIMSS also agrees with the IOM that we should not be complacent; there are ways to make health information technology even safer and better for healthcare providers and the patients they serve.  

HIMSS notes that the scope of the IOM’s Patient Safety & Health IT report was limited, focusing on making health IT safer.  While the deficits of the paper-based system have been well-addressed by IOM in its past publications “To Err is Human” and “Crossing the Quality Chasm”, those deficits still should be noted. The paper-based health system, still in use in many clinical practices and hospitals across our nation, has profound deficiencies in failing to portray a full and up-to-the-minute picture of patients' conditions and care.  The paper-based health system kills.  
As the leader in transforming the health system through the best use of IT, HIMSS has been actively supporting efforts to improve patient safety for years. For example, HIMSS’ 2011-2012 Public Policy Principles call on HHS to launch patient safety initiatives, many of which align with the recommendations made in the IOM report, including:
•Developing strategies to identify and prevent unintended consequences from EHR functionality and other   integrated health IT.
•Launching a patient safety initiative for health IT that (1) takes into account the importance of innovation through the development and implementation of EHR technology and (2) supports the dissemination and incorporation of lessons learned on unintended consequences to enable enhanced patient safety and to minimize adverse events.
•Reporting improvements in patient safety that are directly attributable from the EHR and associated functionality.  
•Creating a forward-looking roadmap that reflects a longer-term national roadmap for health IT interoperability.
•Funding research in the field of human factors related to EHRs and related technologies such as ordering, documentation, and decision support to develop evidence-based usability guidelines for EHRs.  Such guidelines would greatly enhance the safety of care.  Intuitive and easy-to-use systems increase the likelihood of the right decisions being made at the right time for the right patient.
HIMSS strongly believes that electronic health records – effectively implemented using best practice change management protocols in a transparent fashion, and providing comprehensive training to users – have tremendous promise.   As a 51-year-old, member based, mission-focused non-profit organization, HIMSS has dedicated its existence to the transformational promise of health IT to improve the quality, safety, access, and cost-effectiveness of patient care.  
As partners in the National Priorities Partnership and the Partnership for Patients,  HIMSS leverages our national Davies Award and Stories of Success programs to actively recognize innovative efforts to improve patient safety in care encounters. For example, applicants to both programs must submit case studies demonstrating innovative excellence in achieving the 2011 Joint Commission National Patient Safety Goals.  HIMSS uses these case studies to educate and train professionals on the optimal use of health IT for the benefit of patients and their caregivers.
Today, HIMSS submitted its response to NIST’s draft guidance on the usability of EHRs.  Patient safety is a critical factor in EHR use, and HIMSS suggested that the guidance be expanded to focus on the efficiency, effectiveness, ease of use and user satisfaction of the EHR. In particular, user fatigue and frustration can lead to errors or process workarounds, which are also patient safety issues.  HIMSS noted that usability must be aligned with clinical workflow to avoid the risk for patient safety errors, and must include all clinical stakeholders in the testing process.
Through our ability to convene all stakeholders to uncover and solve real-world problems, HIMSS has uncovered many patient safety-related IT lessons learned, and can articulate the perils of poorly-conceived or implemented health IT. We will use the IOM’s report as a lens through which we can further focus our patient-safety initiatives to – first – prevent unintended harm from the use of health IT.  As a thought leader, HIMSS creates an environment in which the open and transparent sharing of examples of unintended harm can be discussed, understood, and applied to prevent recurrence in the future.  
We applaud the IOM’s examination of the relationship between health information technology and patient safety.  The health system has long lagged other industries in its creation, implementation, and transformational use of IT.  HIMSS looks forward to continuing our engagement with the IOM, the federal government, and other authoritative bodies in initiatives that increase the safety, quality, access, and cost-effectiveness of patient care.  
 About HIMSS

HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 50 years ago, HIMSS and its related organizations are headquartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents more than 38,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 540 corporate members and more than 120 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote information and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org.