The Institute of Medicine in a new report made several recommendations calling for better use of health IT to help hospitals reduce diagnostic errors, which are likely to affect nearly all U.S. residents in their lives, Health Data Management reports (Slabodkin, Health Data Management, 9/23).

Report Findings

The report, titled "Improving Diagnosis in Health Care," concluded that most individuals will experience one or more diagnostic errors -- defined as delayed or inaccurate diagnoses -- in their lifetimes (Appleby, Kaiser Health News, 9/22).

Such errors affect one in 20, or about 12 million, patients annually (Health Data Management, 9/23). Further, they account for hundreds of thousands of adverse events and nearly 10% of all patient deaths.

However, IOM said that far too little attention has been paid to such errors as providers focus more on other safety concerns.

Health IT Findings

The report noted that electronic health records can act as barriers to correct diagnoses, noting:

• "Auto-fill" functions can result in erroneous information being entered;
• EHRs often lack interoperability; and
• The volume of inputs and alerts can overwhelm staff (Kaiser Health News, 9/22).

According to the report, "Urgent change is warranted to address this challenge."

Recommendations

Among other things, IOM recommended that vendors and the Office of the National Coordinator for Health IT work to ensure technologies:

• Align with clinical workflows;
• Demonstrate usability;
• Facilitate the flow of information among patients and providers;
• Incorporate human factors knowledge;
• Integrate measurement capability; and
• Provide clinical decision support (Health Data Management, 9/23).

IOM also recommended that:

• ONC require health IT vendors by 2018 to comply with interoperability standards that facilitate the flow of patient information across care settings; and
• Patient access to EHRs include clinical notes and diagnostic test results (Frieden, MedPage Today, 9/22).

In addition, IOM said HHS should require health IT vendors to:

• "Notify users about potential adverse effects on the diagnostic process related to the use of their products";
• Submit their products for routine independent evaluation; and
• Support the free exchange of information about real-time user experiences with health IT design and implementation that negatively affect the diagnostic process.

Comments

ONC Chief Medical Information Officer Andrew Gettinger said, "Those recommendations from IOM are exactly what we're working on," citing ONC's interoperability roadmap (Health Data Management, 9/23).

Meanwhile, Robert Berenson, a research fellow at the Urban Institute who helped write the report, said providing patients with timely access to their records to check for and correct errors "could be a game changer" (Kaiser Health News, 9/22).