Physicians have been using computers for many years to improve medical practice. Many are just now realizing that information technology can be deployed to help patient safety efforts. The results? Reduced medical errors, improved educational efforts, decreased numbers of adverse events, and better clinical outcomes.
"Doing no harm has always been a goal of our profession," says Brian Goldstein, MD, chief of staff for the University of North Carolina (UNC) Hospitals and executive associate dean for UNC School of Medicine, Chapel Hill. "But now we are trying to become more specific in how we go about using various technology tools to help us do no harm. We are adapting this philosophy to the high-tech care environment that we are increasingly working in."
What's confusing to many is that there is no silver bullet in technology — no one tool for physicians to latch on to. And many experts now urge the industry to stop looking for one. The division of general medicine and primary care at Brigham & Women's Hospital in Boston studied the use of information technology to improve ambulatory care patient safety and recommended against the widespread adoption of any particular technology. Rather, the report called for embracing patient safety standards that would drive physicians toward various technologies.
Many choices
The information technology tools that doctors use to increase patient safety run the gamut from simple to complex. Although computerized physician order entry systems are commonly viewed as the pillars of the patient safety movement (to learn more, enter "CPOE" in the search box on this site), doctors are discovering other technologies that can bolster safety. Items as simple as e-mail and screen savers or as complex as electronic medical records, wireless devices, and specialized databases can help keep patients safe.
And while preventing medical errors is the rallying cry of many patient safety initiatives, many physician practices take a much broader view of patient safety, says Richard Rafoth, MD, associate medical director of quality at Everett Clinic, a 200-physician practice in western Washington state that includes two surgical facilities and an advanced imaging center.
"Anything I can do to prevent an adverse outcome is patient safety. It is really just a subset of quality. Just educating the patient can be considered a part of patient safety," Rafoth says.
Keep it simple
Technology to improve patient safety doesn't have to break the bank. Simply thinking of the various ways that information technology can be redeployed could produce patient safety improvements, UNC's Goldstein says.
For example, Goldstein uses e-mail and screen savers to bolster educational efforts at UNC. He routinely sends clinicians e-mail messages with safety information such as national patient safety goals from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In addition, Goldstein uses screen savers to give clinicians easy access to JCAHO's list of potentially confusing or misleading abbreviations that should be avoided in healthcare.
"Just having the information pop up in places that are close to the point of care will remind people and that will help our safety efforts significantly," he says.
Goldstein also implemented online education and testing software from Pathlore Software Corporation that helps ensure that staff members comply with required training.
For example, physicians must complete a training course before administering conscious sedation to patients. The Pathlore software can keep tabs on who has and has not completed the required training. The software keeps tallies on which staff have completed required training on blood-borne pathogens and whether they correctly answered questions about the training session.
Rethink what you have
Many physician practices have already implemented practice management and electronic medical records systems. Although most medical groups embraced these tools to increase efficiency and cut costs, some physicians are rethinking the technology and discovering many patient safety applications.
