Providers Turn To IT To Reduce Health-Care ErrorsProviders Turn To IT To Reduce Health-Care Errors

A government study released Wednesday shows that often-preventable injuries and complications that occur in U.S. hospitals lead to longer in-patient stays, more than 32,000 deaths, and costs of more than $9 billion annually.

Although the study did not evaluate ways of preventing those mistakes and mishaps, some health-care executives and government officials say IT can help reduce at least some of those errors.

"There are some mistakes that technology probably can't help, like leaving a foreign object in a body during surgery. However, there are mistakes that can be avoided through the help of information technologies, like decision-support systems and electronic medical records," says Dr. Eduardo Ortiz of the Agency for Healthcare Research and Quality.

AHRQ is the government agency that conducted the study titled "Excess Length Of Stay, Charges, And Mortality Attributable To Medical Injuries During Hospitalization," which was published in the Oct. 8 Journal Of The American Medical Association. The study was done by analyzing administrative data from 994 acute-care hospitals in 28 states.

The study looked at 18 complications that often occur because of error, including accidental puncture and laceration; complications related to anesthesia; postoperative infections and bedsores; surgical wounds reopening; and obstetric traumas during childbirth. In addition to preventable deaths, these complications also often led to longer hospital stays, totaling 2.4 million extra days a year, according to the findings.

"Medicine is so complex and health-care people are so busy--information systems can help aid the human mind," says Ortiz, who adds that the volume and complexity of information that doctors need to consider before making decisions is akin "to expecting a travel agent to make all their customer reservations in their mind."

Some health-care companies are already deploying IT to help prevent in-patient complications. Sutter Health, which operates more than 30 hospitals in California, is developing an electronic data warehouse that can help track quality indicators for best practices based on evidence, or patient outcomes, CIO John Hummel said Wednesday.

Sutter has begun using the warehouse to track injuries that occur during childbirth and the frequency of induced labors. Hummel said the analysis has already helped the health provider reduce the number of induced labors and maternal tissue tears that occur during childbirth. "We're also using this system to build best practices for beta blockers, bed sores, and several other quality indicators," he said in an E-mail exchange with information.

Decision-support systems integrated with electronic patient medical records can indeed help alert clinicians that certain patients are at risk for developing bedsores, for instance, because of their immobility and other conditions, AHRQ's Ortiz says. The systems can also alert the clinician to possible treatments and drugs to address the bedsores, he says.

Across the country in Boston, CareGroup Healthcare System, which operates five hospitals, is using the CompuRecord Anesthesia Information Management System from Philips Medical Systems to automate anesthesia record keeping before, during, and after surgery. This lets CareGroup physicians and operating room staff "focus more fully on the patient throughout their surgery and hospital stay," Alice Lee, CareGroup VP of clinical systems, said in an E-mail interview with information.

Also, at CareGroup's Beth Israel Deaconess Medical Center, a General Electric Picture Archiving and Communications System digitally captures images, including X-ray, CT, MRI, mammography, and ultrasound, and stores them centrally. Doctors can access the images almost immediately via the hospital's intranet.

"In the operating rooms, we are installing dual high-resolution flat-panel monitors so that the surgeons can view the images prior to and during procedures," Ronald Mitchell, CareGroup's director of radiation information systems, told information via E-mail.

These systems can improve patient outcomes and reduce complications, CIO John Halamka said during an E-mail exchange. Because "all our anesthesia records are created automatically, we know patient vital signs throughout the surgery and are warned when any change in status occurs, and we are advised of best practices," he said. "Through the use of advanced IT systems, we minimize error throughout the [Beth Israel Deaconess] hospital,"

While the U.S. government isn't mandating specific uses of IT in health care, it's looking for ways to provide incentives so that health-care providers might be more willing to invest in systems that can improve patient safety, AHRQ's Ortiz says. Also, the agency is funding a few projects that look at where health-care providers can best mine their data repositories to detect where medical errors and injuries occur, he says.

A 1999 study by the Institute of Medicine found that tens of thousands of patients annually experience adverse reactions--including death--because of drug errors. Since then, the Food and Drug Administration, as well as various health-industry watchdog groups, has been advocating computerized drug and order-entry systems that can help red-flag potential mistakes before they occur.