Recently, “problems with computerized systems” received a ranking as one of the 10 most hazardous technologies in healthcare from the ECRI Institute. ECRI is a nonprofit organization that aims to improve medical care through application of technology to healthcare procedures and processes.
What do we mean… problems? “If systems are poorly planned, implemented, or managed, they can threaten patient safety and lead to inefficiencies, significant interruptions in operations, and uncaptured or lost revenue,” according to their report. In other words, technology is not inherently perfect. As an example, the Joint Commission found that 25% of medication errors in 2006 involved computer technology. See the story.
So how do we avoid the pitfalls? It comes down to “quality data,” as explained in a presentation of the American Health Information Management Association (Quality Data for a Healthy Nation, Mary H. Stanfill, Health Information and Technology Week, 2005). Stanfill says very simply that quality data is current, timely, and comprehensive. It must be accurate and it must be available to decision-makers—the right information in the right place at the right time. She says, “Quality data is the foundation for quality information that results in quality care.”
So why doesn’t quality always happen? Stanfill explains that even in computerized hospitals, “Interfaces from one application to another are often problematic,” and poorly designed IT interfaces are actually a threat to quality of care.
On the other hand, a well designed, real time interface for nutritional care in hospitals can improve patient safety. We want to know about current medications, so we can avoid serving grapefruit juice to a patient who could have a dangerous food-drug interaction. We want to integrate food allergy data with meal service to prevent life-threatening anaphylactic reactions. Based on a synthesis of laboratory data, clinical data, and diet history, we want to flag patients at nutritional risk and target interventions before they get into trouble.
Without health information systems interfaces that include admissions, discharges, transfers, diet orders, diagnoses, medications, up-to-date lab data, and more, clinical dietitians and hospital diet office staff can’t make their best decisions, and patient safety is on the line.
In its statement on Medical Informatics for Better and Safer Health Care, The Agency for Healthcare Research and Quality (AHRQ) agrees: “Informatics can improve decision-making and patient safety.” AHRQ research focuses on electronic medical record system, access to current information, clinical reminders, clinical decision support, electronic communication, patient education and self-management of chronic disease, and more.
How about your nutrition department? Do you have quality data? In real time?