The sad reality is that sometimes, a visit to the hospital or a healthcare provider can make patients more sick. A famous 1998 study, "To Err is Human: Building a Safer Health System," by the Institute of Medicine unnerved the medical community with its assertion that 98,000 Americans die from medical errors each year.
The study sparked health professionals, researchers and lawmakers to reexamine the practices and standards in place in hospitals and health facilities and to look for ways to improve patient safety. However, it seems things may have gotten worse. A 2013 study by John James, Ph.D., of Patient Safety America, upped the estimate of deaths from medical errors to a staggering 440,000 per year. This figure established medical error as the third leading cause of death in the U.S., following heart disease and cancer, miles ahead of car accidents, diabetes and stroke. Many more people are injured each year by mistakes and negligence, making the pool of victims of medical error even bigger.
Many health professionals are calling for an overhaul of hospital and practice systems and procedures to eliminate medical errors. As Emory Hospitals' associate administrator and chief quality officer, Bill Bornstein, wrote:
"The theme is not that we must 'do better' as individuals but rather that we must acknowledge our individual fallibility and implement systemic approaches to reducing and intercepting errors."
While the estimates for the number of patients affected by errors seem to have gone up over the last decade, doctors now have tools for reducing error that were out of reach in 1998: Electronic health records and other digital data systems.
Many of the most common types of medical mistakes could have been prevented with more data. Here are a several examples:
Medication error is the most common type of medical mistake, according to ACP Internist. A 2009 study published in the British Journal of Clinical Pharmacology estimated that medication error harms at least 1.5 million patients every year in the U.S. There are many ways to make a mistake when prescribing a medication to a patient: A pharmacist incorrectly reads the doctor's handwriting, a doctor is unaware of another medication his patient is taking and prescribes a drug that will cause adverse effects when mixed or he misreads information and prescribes an incorrect dose. According to Bornstein, the most errors occur during the physician-ordering step, when it's easy for sensitive information to be miscommunicated.
While there are many ways to make prescription errors, the wrong medication in any situation can be deadly. EHRs and other digital data storage and management systems minimize the risk of human error and keep medication information organized, accessible and easy to understand at every step of the process. Prescriptions are submitted electronically, which ensures the name of the medication is clear. Instead of maintaining a bulky and cluttered spreadsheet or list of active medications, EHRs effectively organize medications and retrieve pertinent information to doctors instantly, noted HealthIT.gov. Electronic data systems can also update their medication lists and profiles when there are recalls or new information about side effects. Furthermore, when a doctor prescribes a drug for a patient, the system can alert him whether he has any allergies or if there's the potential for a harmful drug interaction.
EHRs are even more vital today, since the idea of staying with only one doctor is becoming antiquated, according to Psychology Today. A patient will likely see several doctors, and it can be difficult to coordinate a multitude of diagnoses and prescriptions. Digital systems help cross-check and coordinate patients' care plans.
Inattention to testing
Another type of medical mistake involves those related to testing. Doctors may order the wrong test or fail to perform one altogether. ACP noted that practices process dozen of tests - or more - every day, and that it is easy to lose track of who needs what when. The source added that there are additional issues, such as when a patient does not show up for a scheduled test or when staff do not notice abnormal results.
EHRs can help prevent testing error by streamlining the test scheduling, administration and follow-up process. Each patient receives a profile outlining the tests they have already had and the ones they need, and doctors and nurses will clearly see these tests in their schedules through the system. Doctors and nurses can easily view each patient's testing plan, and can see if a test needs to be rescheduled. Additionally, ACP recommended that physicians adopt an EHR system that flags any test results that are abnormal to ensure that doctors follow-up.
"Patients that require follow-up care and monitoring can be forgotten once they are sent home."
Failure to follow-up
Insufficient follow-up by doctors is a major medical error that can lead to serious health issues or fatalities. Studies have found that one in three Medicare patients are readmitted to the hospital within 30 days of discharge, according to Psychology Today. Patients that require follow-up care and monitoring can be forgotten once they are sent home. EHRs keep a profile of every patient and set reminders for doctors to check-in and reevaluate the health and needs of the patient. Additionally, when patients do return for follow-up appointments, they can enter details on the status of their condition in an EHR system to provide a more comprehensive picture of their health that doctors can then use to adjust their follow-up plans. Digital systems help make sure that no patient falls through the cracks.