Thank you for this resource.

I write to state that the data is not there to support using current HIT iterations on patients with complex illness and whose lives depend on pinpoint accuracy. MAUDE data cause distrust for these systems. You never know when the unexpected will rear its ugly head. Once you know where to look for patient care errors in this technology, they are abundant and do reach the patient.

Certainly, there will not be billions in savings as concocted by the US Government who based opinion on HIT industry sponsored “study”.

If the vendors wish to experiment to improve their devices to make them user friendly, safe and effective, then declare all current deployments and “go lives” (or deads) as experiments. Then get IRB approval and determine and record the dangers and injuries to patients, explore each unexpected death; and report the data to the FDA.

It has been suggested by other commenters on this dynamic blog for users to report problems of these computerized ordering machines to the FDA.

While you are at it, write to your Congressmen (and women) to educate them that CCHIT Certification is not a stamp of safety and efficacy.

Can you post a URL so that I can look at the study where those numbers came from, or is this some Obamanian set of “facts” that are supposed to prop up an agenda?

Heck, if we’re going to use funny numbers, then lets take the real data, ie the Pharmacopedia data that shows that the EMR gives us 3.5 (to make this exercise easier, we’ll round down to 3) times more errors, then multiply it to your numbers, then voila, you end up with the following for EMR use:

– 45 Million injuries caused by prescribing errors,
– 21000 deaths
– Resulting in ~ 10.5 Billion in costs per year, and
– almost $3 billion to Medicare alone.

I feel that these numbers are more realistic… although without a study, they don’t mean much, and likewise are pure garbage.

Al

However there are still 1.5 Million injuries caused by prescribing errors, 7000 deaths, every year that are not caught down the line. Resulting in 3.5 Billion in costs per year, and $887 million to Medicare alone.

Many are caused by “sounds like” errors, many by interaction problems, many by allergic reactions. These are human errors, that can be easily reduced using IT. Can anybody come up with a paper based system to reduce these errors, or should we just live with them?

Of course a Physician who is sloppy in the paper world is likely to be sloppy in an electronic world as well. So HIT is no magic bullet. But when we have accurate data, we can protect the Physician and the patient from mistakes. There are no valid and credible studies that show otherwise.

http://docs.google.com/gview?a=v&q=cache:d1RqItJzBuAJ:www.iom.edu/File.aspx%3FID%3D35943+National+Academies+of+Science’s+Institute+of+Medicine+(IOM),+preventable+medication+mistakes+also+injure+more+than+1.5+million+Americans+annually&hl=en&gl=us&pid=bl&srcid=ADGEESigSrFxzh2QkKmcdNvVbVMVBENnxmFaCPA6f5htqpKZ1JMCSeEVZoCOI_4kra5_xgbs8xJYUUtGoOfBMY96-MU3yIdlRHo9dP-J-kAMFymcVNe3BXVjJxsf1ui7l6ePKmfvfEMa&sig=AFQjCNHC7wPOpHeTNsNEtppbjQ4lmuytPw

What is it with people who post studies to back up their case, but fail to read them? Sadly Pharmacopeia’s report is pay only, I assume Al just read the article and not the full report, if he has he would know it does not back up his case. It shows reductions in errors when using prescribing, it shows the drop off of handwriting errors are due to people using prescribing and HIT more. And that was 2003. I am sure since 2003 HIT has reduced handwriting medication errors even further.

[From Mr. HIStalk] Be careful about intermingling “reducing medication errors” with “reducing patient harm”. The Lucian Leape systems theory study found what most clinicians known intuitively — transcription and interpretation errors are nearly always caught downstream of the doctor by a pharmacist or nurse and therefore rarely reach the patient, so while bad handwriting does cause patient harm, it’s not a major cause overall. Most of the really harmful errors involve incorrect dispensing or administration, not doctor ordering, which is why bedside barcoding of medications and smart IV pumps almost certainly save more patients than CPOE systems. Nurses and pharmacists don’t have the safety net that doctors do for someone else to catch their mistake. Reducing errors that were already being caught is a good, but not necessarily great thing. Better still would be to attack those that weren’t being caught, the best hope for which is still technology, just not the usual CPOE systems that hospitals are often buying and sometimes using.