In 1991 the Institute of Medicine (IOM) issued a report on improving patient records which has proven to be a landmark for the many individuals and institutions involved in the development of computer-based patient records (CPRs). The report called Computer-based Patient Records: An Essential Technology for Health Care, recommended that CPRs become the primary form for patient records, and urged widespread implementation of CPRs within a decade.
The IOM coined the phrase CPR, which is now referred to as EHR (electronic health record).
Regardless of the ever-greater demands of information capabilities called for in the IOM patient records report, advancement was sluggish until 1999. That was the year the IOM published another landmark work that shocked the nation into true action.
To Err Is Human was the first in a series of reports portraying the U. S. “healthcare quality chasm.”
This report emphasized two studies. One study approximated that medical errors kill 44,000 people in U. S. hospitals yearly and the other study approximated the number was closer to 98,000 deaths per year.
Headlines in national newspapers opined that even in view of the lower estimate, these deaths exceeded those from highway accidents, breast cancer, or AIDS. The media further declared that these deaths were comparable to a 747 aircraft crashing and killing all its passengers every day – without the culpability for investigation that the Federal Aviation Agency completes on every crash.
The report stressed that there were no “magic bullets” to correct this tragedy but building a culture of safety – without attaching blame to individuals – was vital.
The report recommended that well-understood safety standards should be implemented, such as planning jobs and working conditions for safety: standardizing and simplifying equipment, supplies, and procedures; and avoiding reliance on memory through automated information and decision support systems (IOM 1999, 22, 34).
Sadly, a more recent study by HealthGrades (2008) found nearly double the number of deaths from medical errors. This further serves as a wake-up call for embracing technology to improve patient safety. It has also been discovered that care delivery organizations with EHR’s are more likely to report adverse events (Merrill 2009).
The IOM has not stopped encouraging use of “computational technology for effective health care,” the title of the 2009 research study conducted in conjunction with the National Research Council. Where the IOM’s series of reports on medical errors described the need to cross the “healthcare quality chasm,” this report describes the need to cross the “healthcare IT chasm.”
The study included onsite visits to eight medical centers around the country recognized as leaders in joining IT with healthcare. Even with finding several successes and substantial money expended on IT, the report detected that “today’s healthcare fails to deliver the most effective care and suffer substantially as a result of medical errors. In addition, many medical interventions undertaken today are in fact not necessary” (Stead and Lin 2009, 3).
The report comments that “these persistent problems do not reflect incompetence on the part of healthcare professionals, rather they are a consequence of the inherent intellectual complexity of healthcare taken as a whole and the medical care environment that is not adequately structured to help clinicians avoid mistakes or to symptomatically improve their decision-making and practice” (Stead and Lin 2009, 3).
Legal nurse consultants (LNCs) assist attorneys with the high stakes field of medical errors litigation. We help attorneys negotiate the most complicated medical aspects of their cases with insider knowledge grown from years on the front lines of the healthcare community.
Our LNCs can also recognize breaches in the standard of care in a medical malpractice case. They help attorneys identify their strong cases and stop them from taking on weak cases. Our LNCs also provide many other valuable functions, such as determining proximate cause for client injuries, assessing damages, and assisting with case strategy.
Call Krug Consulting today to review your cases involving EHRs.
Click to call us at 1 (844) LNC-KRUG • or Contact Us via email
References and Resources
Institute of Medicine. 1999. To Err is Human: Building a Safer Health System, edited by L.T. Kohn, J.M. Corrigan, and M.S. Donaldson. Washington, DC: National Academies Press.
HealthGrades. 2008. Fifth Annual Patient Safety in American Hospitals Study. Golden, CO: HealthGrades.
Merrill, M. 2009 (December 9). Doctors with an EMR are more likely to report adverse events. Healthcare IT News. http://www.healthcareitnews.com.
Stead, W.W., and H.S. Lin, eds. 2009. Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. National Research Council of the National Academies. Washington, Dc: National Academy Press. P. 3.