Putting A Clamp On Medical MishapsPutting A Clamp On Medical Mishaps

A government study released last week shows that often-preventable injuries and complications that occur in U.S. hospitals lead to longer in-patient stays, thousands of deaths, and billions of dollars in excess charges.

Although the study doesn't evaluate ways of preventing these errors, some health-care executives and government officials say IT can help reduce the risks. "There are some mistakes that technology probably can't help, like leaving a foreign object in a body during surgery," says Dr. Eduardo Ortiz of the federal Agency for Healthcare Research and Quality. "But there are mistakes that can be avoided through the help of technologies like decision-support systems and electronic medical records."

The agency conducted the study, "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, which analyzed administrative data from 994 acute-care hospitals in 28 states, looked at 18 complications that often occur because of errors, including accidental puncture and laceration, complications related to anesthesia, postoperative infections and bed sores, surgical wounds reopening, and obstetric traumas during childbirth.

"Medicine is so complex and health-care workers are so busy that information systems can help the human mind," Ortiz says.

Some health-care companies are already deploying IT to help prevent in-patient complications. Sutter Health, which operates more than 30 hospitals in Northern California, is developing an electronic data warehouse that can track quality indicators for best practices based on patient outcomes, CIO John Hummel says. Sutter has begun using the warehouse to track injuries that occur during childbirth, as well as the frequency of induced labors. The analysis has already helped the provider reduce the number of induced labors and maternal tissue tears, Hummel says.

In Boston, CareGroup Healthcare System, which operates five hospitals, uses a 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 patients, says Alice Lee, CareGroup's VP of clinical systems.

At CareGroup's Beth Israel Deaconess Medical Center, a General Electric Co. picture-archiving and communications system digitally captures images, including X-rays and CT and MRI scans, and stores them centrally. Doctors can access the images almost immediately via the hospital's intranet. "In the operating rooms, we're installing dual high-resolution flat-panel monitors so that surgeons can view the images prior to and during procedures," says Ronald Mitchell, CareGroup's director of radiation information systems. These systems can improve patient outcomes and reduce complications, adds CareGroup's CIO, Dr. John Halamka.

While the U.S. government isn't mandating specific uses of IT in health care, it's looking for ways to offer incentives to encourage providers to invest in systems that can improve patient safety, Agency for Healthcare Research and Quality's Ortiz says. The agency funds several projects that examine how 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 and various health industry watchdog groups have advocated computerized drug and order-entry systems that can warn about potential mistakes before they occur.