The need for integrated patient care to help reduce medical errors, a $20B plague for U.S.
The U.S. health care system, among the best in the world with highly skilled clinicians trained at the world’s leading medical schools, suffers a fatal flaw: medical errors, which are responsible for roughly 1 in 10 American deaths and cost the country $20 billion a year. Nearly 2 out of 3 of these errors are rooted in poor communication among the care team.
Poor communication ranges from a misheard word in a noisy emergency department to a mistaken patient identity. Breakdowns are most likely to occur in patient handoffs across departments, from primary to secondary care, at the change of shifts, and across professional boundaries. Hierarchies, high acuity settings (e.g., operating rooms), and multiple treatment sites also complicate care.
Amid proliferating telehealth and other arms-length encounters during the COVID-19 pandemic, an error is likely to be administrative in nature, linked to communication gaps within the electronic health record (EHR) and other provider systems.
Often the glitch is the inability of the system(s) to integrate data from all care teams who see patients – including primary and secondary care, emergency and outpatient care, and teams treating disparate comorbidities – as well as all of the ancillary applications involved in health care delivery.
Presentation of that data is another issue. Even though clinicians’ notes, prescriptions, diagnostic results, visits, vitals, histories, insurance, and other records pertaining to a patient are online, that hardly means they’re easily accessible to every busy clinician who sees the patient. Clinicians must either dig for information, often switching among multiple devices and applications, or proceed with an incomplete picture.
Burnout from bad tech can lead to medical errors
Worse, many clinicians are arriving at these encounters burned out on bad technology. Even prior to the pandemic, burnout had reached crisis levels with as many as 54% of nurses and physicians and 60% of medical students and residents reporting symptoms, according to the U.S. Surgeon General.
A myriad of factors contribute to burnout, including “burdensome administrative paperwork” and “lack of human-centered technology,” according to the report. “For every hour of direct patient care, physicians currently spend two hours on the Electronic Health Record (EHR) system,” the report says. “Nurses spend up to 41% of their time on EHRs and documentation.”
Lacking the time and appetite for getting mired in a tangle of applications, clinicians often treat the patient based on what they know at the time of the visit and what the patient tells them (or doesn’t).
Although death is the worst-case scenario, errors and miscommunication often result in “mere” suboptimal care and flagrant waste. These problems plague all areas of health care delivery, including diagnosis, treatment, scheduling, referrals, and billing. Unfortunately, even the most comprehensive treatment plan is likely to fail without connecting and coordinating all health care providers involved.
How EHRs can reduce costly mistakes
EHRs are essential tools that have the ability to help reduce medical errors and the expense they bring. This is especially true when the EHR delivers a personalized experience that integrates information from all relevant systems in the health care delivery chain. Here are seven elements of an EHR that can significantly reduce the instances of poor communication between medical providers that ultimately lead to costly mistakes.
EHRs that work like this could help reduce medical errors and unnecessary expenses by enhancing communication in an easy to use way. By leveraging data from all sources, including clinicians’ spoken words, and systematically integrating it around every patient for each health care worker’s role, we can intelligently present information to each clinician and staffer involved in any aspect of health care delivery – including clinicians from different disciplines treating the same patient for different conditions.
Errors will happen, but many of them are avoidable. We know where problems lie and how to fix them. Let’s do it.
Khalid Al-Maskari is founder and CEO of Health Information Management Systems (HiMS), a Tucson, Ariz.-based company that designs Electronic Health Records (EHR) software to transform the integrated health care experience. HiMS creates innovative solutions that lead to better outcomes, lower costs and higher-quality care.