- WHAT: Texas’ physician representatives to the
American Medical Association (AMA) House of Delegatesgoverning body will ask AMA to beef up
oversight of electronic health records (EHRs), with the ultimate goal of
improving patient safety. The delegation will urge passage of a resolution
urging AMA to work with Congress to create a National Health Information
Technology (IT) Safety Center to reduce EHR-related patient safety risks.
- WHEN: June 11-15, 2016
- WHERE: Hyatt Regency Chicago,
(Reporters: Please contact
TMA media relations to set up a phone interview with a member of the Texas delegation
attending the conference. See a list of Texas delegation
- WHO: Texas delegation attending
the American Medical
Association’s House of Delegates meeting
- WHY: Doctors
say patient safety is threatened because of a recent surge in EHR adoption — due to rapid
technology changes imposed by the Centers for Medicare & Medicaid (CMS) meaningful
use (MU) program — and inadequate oversight of identified risks.
The problem, physicians say, is when an error as simple as a typo
is written into the computer software physicians use, there is little oversight
to catch that error, alert all physicians and other health professionals who
use the software, and to ensure the software vendor fixes it.
Therefore, Texas AMA delegates say, the electronic health
information physicians gather and use to treat their patients is at risk … and
sometimes the patients are at risk, too. The Texas doctors’ proposed IT safety
center would serve as a clearinghouse for all EHR safety-related incidents and
“near-misses” in which no patient harm occurred but an error in the software
One example Matt Murray, MD, chair of the TMA Ad Hoc Health IT
Committee, cites is a situation where instructions for a child’s insulin dosing
were entered correctly into EHR discharge instructions, but the EHR’s printed patient
instructions had a decimal point error, suggesting a dosage 10 times higher
than required. A nurse noticed the error, corrected it manually, and reported
the near-miss to the EHR vendor, which then corrected the technical problem.
However, the software vendor didn’t plan to warn other physicians nationwide
because no other doctor had reported such a problem.
“I envision that this resolution would lead to an entity that has
the authority and influence to drive improvements in EHR usability and
interoperability,” said Dr. Murray, “which are the two most significant
impediments to effective and [gasp!] meaningful use of EHRs.”
Dr. Murray says passing the resolution could ease the pressure on physician
practices that are required, under the CMS MU program, to adopt and EHR into
their business models. In the past 10 years, EHR use by
physician practices in Texas has increased exponentially to 70 percentaccording to surveys by TMA.
However, Texas physicians say EHR vendors have not been held
accountable for poor usability problems and lack of interoperability among EHR
systems — both of which are patient safety risks that physicians commonly
encounter. The resolution would require EHR developers to report patient safety
incidents and near-misses to the Health IT Safety Center.
“Physicians are assuming a higher level of risk and accountability
for computer programs, networks, and infrastructures that are increasingly used
as tools to generate patient care actions and facilitate medical decisions,” said
Dr. Murray. “Although health IT-related patient safety risks would best be managed
through a shared accountability between physicians and EHR vendors, the vendors
are not currently held accountable for patient safety.”
The resolution, one of hundreds AMA will consider at its meeting, recommends
the proposed Health IT Safety Center:
- Accept reports of patient safety incidents involving EHRs and
near-misses from EHR vendors similar to how transportation safety incidents
must be reported to the National Transportation Safety Board;
- Collect, aggregate, and analyze reported EHR data;
- Investigate incidents involving patient harm, and require EHR
vendors to make appropriate changes;
- Monitor EHR incidents and near-misses to identify trends and risks;
- Coordinate with other agencies to develop and broadly disseminate
educational information and tools that mitigate identified patient safety risks
related to technology use.
TMA is the largest state medical society in the
nation, representing more than 49,000 physician and medical student members. It
is located in Austin and has 110 component county medical societies around the
state. TMA’s key objective since 1853 is to improve the health of all Texans.
Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear[at]texmed[dot]org
Cooper (512) 370-1382; cell: (512) 650-5336; email: marcus.cooper[at]texmed[dot]org
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