Institute of Medicine Report on HIT

Originally posted 11-9-2011:
The Institute of Medicine (IOM) issued a report yesterday around the safety issues with Healthcare Information Technology (HIT). The report, titled "Health IT and Patient Safety: Building Safer Systems for Better Care" was released by the same organization that released the "To Err is Human" report which triggered the Patient Safety initiatives of the past decade. I knew this report was in the works, and am glad to have seen it finally come to light.   I have not had a chance to read through the report yet, but there is a good summary that hits on the key points of the report.

Plain and simple, the report covers the growing number of reports of patient harm caused by HIT systems. Combine that with the Meaningful Use incentives, I think the concerns raised in the report are valid. Studies have shown that HIT systems can promote better patient outcomes, but there have been clearly documented side effects. The problem is, there are no standards or regulations to encourage safer software. There is not a mandatory reporting system, like the FDA has for medical devices. I have said this before, but how can healthcare leaders learn from mistakes without understanding where the healthcare system broke down?

I am glad to see the report is making a recommendation that there needs to be reporting of safety breakdowns of these systems. I am also happy to see that the group feels there needs to be an organization overseeing HIT with an eye toward safety. I wonder if the FDA would be the appropriate group, and we should consider HIT as a medical device. The FDA isn't perfect, but I would imagine expanding the FDA would be easier than creating an entirely new government organization.

I was also glad to hear the report say that “poor user interface design, poor workflow, and complex data interfaces are threats to patient safety". User Centered Design (UCD) techniques are clearly needed to address these concerns. And I'm not just saying that to push my own job security. The work and research have been done to show that UCD will help improve the usability, and ultimately, the safety of these systems.

I have said before, I don't want the FDA or other government agency dictating my designs. But I am on board with there being regulations to ensure HIT systems are usable, safe, and meet their purpose of improving patient outcomes.