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Health IT Patient Safety and Surveillance and Action Plan. David R. Hunt, MD, FACS Medical Dir., HIT Adoption & Patient Safety ONC, Office of the Chief Medical Officer. ONC Pre-decisional Draft. Do not disclose.

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health it patient safety and surveillance and action plan

Health IT Patient Safety and Surveillance and Action Plan

  • David R. Hunt, MD, FACS
  • Medical Dir., HIT Adoption & Patient Safety

ONC, Office of the Chief Medical Officer

  • ONC Pre-decisional Draft. Do not disclose.
slide2
“Doubt is uncomfortable, but certainty is ridiculous… From the depth of our profound ignorance, let us do our best;…”

-- Voltaire

Letter to Frederick William, Prince of Prussia

Ferney, November 28, 1770

goals

Goals:

Goals
  • Use Health IT to Make Care Safer
  • Improve the Safety and Safe Use of Health IT
goals continued
Goals Continued
  • Addresses the role of health IT within HHS’s commitment to patient safety.
  • Responds to ONC sponsored IOM Report
  • Builds upon existing authorities
  • Seeks to strengthen patient safety efforts across government programs and the private sector
questions
Questions:
  • Meaningful Use and Safety Risk Assessment:
    • To improve the safety of EHRs, should there be a Meaningful Use requirement for providers to conduct a health IT safety risk assessment?
    • Are there models or standards that we should look to for guidance?
  • Meaningful Use and Reporting:
    • Should ONC require any form of reporting/reporting verification under Meaningful Use?
questions1
Questions:
  • What should be the next steps in terms of EHR technology certification?
    • Certified EHR technology developers will be required to publicly identify a method of incorporating user - centered design of eight certification criteria that have a high likelihood of helping to prevent medical errors (77 Fed Reg 54186-54189 (September 4, 2012)).
    • Certified EHR technology developers will also be required to provide transparency regarding their approach to “quality management systems,” (77 Fed Reg 54189-54191 ((September 4, 2012))
background 2011 iom report
Background: 2011 IOM Report
  • Response to ONC sponsored IOM Report Published Nov. 2011
  • 10 Recommendations
institute of medicine 2003
Institute of Medicine, 2003

Patient Safety: Achieving a New Standard for Care: November 2003

fundamentals
Fundamentals

In: Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology). Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb

safe ty

safe·ty:

n. (sāf’tē), [L. salvus ] :

the quality or condition of being free from harm, injury, or loss

Webster’s New 20th Century Dictionary Unabridged

claudius galen 129 217
Claudius Galen(129 – 217)

“Primum nonnocere.”

hippocrates of kos
Hippocrates of Kos

Hippocrates of Kos

(ca. 460 BC – ca. 370 BC)

“As to diseases make a habit of two things - to help, or at least, to do no harm.”

Epidemics I

goals1
Goals

Goals

Health IT to Make Care Safer

  • Improve the Safe
  • Use of Health IT
goals2
Goals
  • Health IT can improve patient safety in some areas such as medication safety; however, there are significant gaps in the literature regarding how health IT impacts patient safety overall
  • Safer implementation and use begins with viewing health IT as part of a larger sociotechnicalsystem
  • All stakeholders need to work together to improve patient safety
patient safety action surveillance plan
Patient Safety Action & Surveillance Plan
  • Learning: Increasing the quantity and quality of data and knowledge about health IT safety
  • Improving: Targeting resources and corrective actions to improve health IT safety and patient safety
  • Leading: Promoting a culture of safety related to health IT
learning overview

Learning: Overview

Learning: Overview
  • Clinicians

Encourage and facilitate clinicians reporting of health IT – related safety events

  • Developers

Encourage health IT developersto embrace their shared responsibility for patient safety

  • Safety Programs

Incorporate health IT into existing safety programs, e.g. PSOs/AHRQ, CMS, AHRQ

  • ONC Pre-decisional Draft. Do not disclose.
learning safety programs

Learning: Safety Programs

Learning: Safety Programs

Reporting

  • AHRQ/PSOs

Accrediting

  • ONC-ACB
  • CMS
  • ONC Pre-decisional Draft. Do not disclose.
patient safety action surveillance plan1
Patient Safety Action & Surveillance Plan
  • Learning: Increasing the quantity and quality of data and knowledge about health IT safety
  • Improving: Targeting resources and corrective actions to improve health IT safety and patient safety
  • Leading: Promoting a culture of safety related to health IT
improving

Improving:

Improving
  • AHRQ/PSO

AHRQ will provide technical guidance to help PSOs work with providers to mitigate harm and improve safety through health IT

  • CMS

CMS will provide guidance to surveyors and accreditation organizations to recognize health IT – related adverse events when conducting surveys on CMS’ behalf

  • ONC-ACBs

ONC-ACBs will conduct live testing in clinical environments to determine whether clinician safety complaints are addressed and whether EHR safety features are performing adequately.

  • ONC Pre-decisional Draft. Do not disclose.
patient safety action surveillance plan2
Patient Safety Action & Surveillance Plan
  • Learning: Increasing the quantity and quality of data and knowledge about health IT safety
  • Improving: Targeting resources and corrective actions to improve health IT safety and patient safety
  • Leading: Promoting a culture of safety related to health IT
is safety meaningful
Is Safety Meaningful?

“We cannot change the human condition, but we can change the conditions under which humans work.”

James Reason

Human error: models and management

BMJ 2000; 320: 768-70

thank you
Thank You

Contact Information

davidr.hunt@hhs.gov

www.healthit.gov

Thank you.