MALAGA, SPAIN – Some 10 per cent of hospital admissions cause harm to the patient – and in most cases could have been avoided.
In the U.S. alone, 44,000-98,000 deaths every year can be attributed to medical error – that’s 11 an hour. “It’s like playing Russian roulette when you go to the hospital,” said Prof. Kendall Ho with the University of British Columbia‘s Faculty of Medicine, who spoke about the benefits of ICTs for patient safety at the fourth annual global eHealth conference being held here this week.
Information and communication technologies could dramatically improve patient safety, but there are still concerns over data confidentiality and weak information systems, said John Ryan, directorate general of health and consumer protection with the European Commission. Research projects are proposing the development of tools to mine complex data for research into patient safety, which could be applied to electronic health records.
Medical errors can occur at all levels, said Ho, including diagnostic, treatment, preventive, even equipment or system failures. The challenge is to put technology at the point of care to monitor a patient’s reaction to medication.
Take Vioxx, which was introduced in the late 90s. In 2004, Merck, the pharmaceutical company that developed Vioxx, announced a voluntary withdrawal of the drug, and in 2005, the FDA pulled it off the market. Thanks to electronic monitoring, a Kaiser Permanente study found that 2,210 fatalities could be attributed to Vioxx. This data was the “whistle blower” for the FDA, leading it to pull the drug off the market.
“IT leads to monitoring, which leads to prospective evidence, which leads to patient safety,” said Ho.
In Canada, medication side effects are generally reported by industry – only 10 per cent of case reports are from health professionals. This is because the procedure is not IT-based, said Ho, adding there needs to be a focus on developing a Web community and improving the ability to get reports.
ICTs could help prevent medical errors, said Dr. Jean-Pierre Thierry with Symbion in France, who conducted an e-Health for Safety study. But there’s still an issue with the quality and safety of technology, with a 30 per cent failure rate of medical software systems. “Software should not be risky,” he said, adding there needs to be a certification and accreditation process for medical software companies.
Externally, technology could help in the case of a future influenza epidemic in the areas of prevention, preparedness, disaster management, planning, tracking and crisis management. ICTs can play a role in the management of pandemics at a global level, he said, particularly for undeveloped countries.
Another issue is process complexity at the point of care, which needs to be more efficient, said Dr. Alberto Sanna, e-services for life health manager with the Scientific Institute Hospital San Raffaele in Italy.
Not only is there a need for an e-prescription system for doctors, but also an e-prescription validation system for pharmacists and an e-preparation/administration system for nurses. “It will only work if we integrate the supply chain up to the knowledge chain,” he said. Eight per cent of pharmaceutical drugs being consumed around the world are counterfeit, so increased efficiences at the point of care could help to address this.
B.C. plans to complete a provincial e-prescription system within the next two years. Two paradigm shifts are occurring at the same time, said Ho, so there’s an opportunity to improve patient safety while at the same time deploying e-health.
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