HHS shouldn't allow cuts to alter health IT safety efforts

With all of the attention the Healthcare Information and Management Systems Society's annual conference in New Orleans this week is receiving, did you also know that this week is Patient Safety Awareness Week? Somehow that's not getting the same fanfare in my emails or on my Twitter feed. While the two events are not connected, though, each has paid some homage to the other.

Patient safety and electronic health records are not themes for this year's awareness week, but the National Patient Safety Foundation's website does have a members-only module addressing health IT and patient safety. And the topic crops up regularly on the Foundation's patient safety list serve, which is available to all. 

And HIMSS is doing an even better job of covering health IT and patient safety. A number of educational sessions at this year's conference addressed the topic, including one on electronic health record best practices, and another specifically about leveraging EHRs to improve patient safety.

And not a moment too soon. These days it seems that for every report on how EHRs improve patient safety, there's one that says that EHRs don't help and that their use can actually increase the risk of harm. In taking a closer look, it seems that EHRs improve patient safety when used in a "big data" way, such as data mining, creation of clinical decision support alerts, and large-scale population health research. However, it appears that on the individual patient level, they're falling short, with sloppy copy and pasting and other mistakes compromising the records.

And now we have sequestration kicking in, which only will make the latter worse. It will slash billions of dollars from Medicare and other health programs, which according to provider representatives, will reduce preventative care and otherwise adversely affect patient safety.

It also is expected that sequestration will reduce EHR adoption by providers and reduce research, including research using EHRs. Sequestration will even adversely affect the Meaningful Use incentive program for Medicare, according to National Coordinator for Health IT Farzad Mostashari. EHRs won't be utilized to their potential in the very areas where they shine in patient safety.

Congress last week asked each federal agency--including HHS--to identify programs and initiatives that could be reduced or eliminated as an alternative to sequestration's automatic budget cuts.

What might HHS be willing to abandon or drastically scale back? Probably not programs that already are in effect, since there's been an investment there. I'm guessing that HHS instead would slash programs that are just in the beginning development stages, such as its health IT patient safety initiative, although department officials did announce at HIMSS that they anticipate a final health IT safety plan by early summer.

I hope not, though. EHRs and patient safety will only become even more pressing issues as adoption for the former grows. HIMSS 2013 and the National Patient Safety Foundation have made some inroads, but the private sector can't do this on its own. This issue needs input and endorsement from government stakeholders, as well. - Marla (@MarlaHirsch)