Tuesday marked the 10th anniversary of the publication of To Err Is Human, the eye-opening Institute of Medicine report with the now-familiar assertion that preventable medical errors in U.S. hospitals kill 44,000 to 98,000 people every year. The landmark tome, plus a follow-up report, Crossing the Quality Chasm (2001), and other subsequent IOM publications called for greater use of health information technology to help reduce the number of mistakes and assure greater care coordination.
Progress in the last decade has been slow, particularly in the technology realm. Just 17 percent of hospitals have "functioning" computerized physician order entry, and only 2 percent have fully integrated IT systems with EMRs, CPOE and clinical decision support in all clinical units, according to Dr. Robert Wachter, associate chair of the Department of Medicine at the University of California, San Francisco. Writing in Health Affairs, Wachter gives quality improvement efforts a grade of B-minus, up from the C-plus he awarded in 2004. But health IT only merits a C-plus.
"Several major installations of vendor-produced systems have failed, and many safety hazards caused by faulty health IT systems have been reported," Wachter writes. "Although some provider organizations have implemented health IT systems and report major improvements in safety-related areas, overall progress has been stunningly slow."