The idea of a health IT safety collaborative in which developers, providers and practitioners could work together to resolve safety concerns associated with EHRs has been around for more than six years, but it's never come to fruition.
Pew Charitable Trusts is taking another stab, reviving the argument that a public-private collaborative would help the industry solve complex safety concerns, but with a price tag as high as $20 million.
A new report (PDF) released by the organization this week recaps some of the discussion points from a meeting with the Office of the National Coordinator for Health IT last December and advocates for a national health IT safety collaborative that could root out EHR usability issues that lead to medical errors.
Pew argues that the current approach to monitoring EHR safety—which includes product testing, government oversight and reporting through patient safety organizations—does not adequately address safety concerns that have emerged since the implementation of EHRs.
“Several limitations are clear: Each organization analyzing safety may lack the expertise to address complex health IT issues, the ability to disseminate its findings on a national scale, or sufficient data to generalize its research,” the report states.
In an accompanying video released by Pew, Terry Fairbanks, M.D., associate director of MedStar’s Institute for innovation, explains how even a simple autorefresh error can prompt a physician to pull up the wrong patient’s x-rays.
While a national collaborative admittedly “may not solve every concern,” it would encourage more reporting from all stakeholders at a national level, collect actionable data on EHR safety events and prioritize health IT-specific risks.
Funding remains a concern. Pew cites a 2015 report by RTI International prepared for ONC that indicates optimal funding for a national collaborative would fall somewhere between $17.8 million and $20.6 million over a five-year period. Even a bare-bones approach would cost $9.1 million to $10.5 million.
That kind of capital seems unlikely with ONC facing a $22 million budget cut that has forced the agency to trim down its operations. Although ONC Chief Medical Officer Andrew Gettinger, M.D., has previously called for more funding from Congress to address EHR safety, other officials have said the agency doesn’t have enough money to establish an EHR reporting program as required under the 21st Century Cures Act, which drew the ire of Pew and the American Medical Informatics Association.
Still, EHR safety has become a pet project for organizations like Pew and the ECRI Institute. EHR management topped ECRI’s annual list of patient safety concerns earlier this year, and researchers have pushed for IT staff to be included in daily safety huddles to address localized safety concerns that may be linked to medical records.