Politico’s Arthur Allen has written a useful report on recent findings about EHR-related errors. We must keep in mind, however, that almost all EHR-related errors are unknown, and often unknowable. Why?
- The most common errors involved with EHRs are medication prescribing errors. But we seldom find those errors because those type of errors seldom manifest themselves because so many hospitalized patients are old and sick, have several co-morbidities and are taking many other medications. Key organs, like the liver, kidney and heart, are compromised. Bad things can happen to these patients even when we do everything right; conversely, good things can happen even when we do much wrong. We usually miss the results of, say, a wrongly prescribed medication. (Note: these types of ‘missed’ medication errors contrast to leaving a pair of hemostats in the gut or to wrong-site surgery—where most errors soon become obvious).
- As the experts referenced (Dr. Bob Wachter, Dean Sittig and Hardeep Singh) noted, very, very few cases make it to litigation, further reducing the numbers examined in the study discussed.
- Perhaps worse, few clinicians want to report problems even if they know about them. This is a litigious society and few medical professionals want to spend time in court. Also, as the authors Allen interviewed (all of them my friends and respected colleagues): some of the errors that were known did not result in harm and many were caught by others or by the professional involved in the error before they harmed.
The idea that payment should be linked to the value lies at the heart of most of the transactions we participate in on a daily basis. Yet, value based payment in healthcare has seemingly run into very rocky waters as of late. It is at this precarious time that stakeholders representing large employers and other purchasers of health care’ took to the Harvard Business Review to
If you had illusions, or hopes, that the “Kill Obamacare” reality show starring Donald Trump would settle down to a dull roar, events of the last few days should blow those illusions out of the water.
Some things never change. Joe Flower is one of those things. Pay attention. Joe was the keynote speaker at Health 2.0 Silicon Valley earlier this month. We’re excited to feature the text of his remarks as a post on the blog today. If you have questions for Joe, you can leave them the comment section. You’ll find a link to a complimentary copy of his report Healthcare 2027: at the end of this post. You should
The Center for Medicare and Medicaid Innovation released a Request for Information (RFI) last week– “
There’s a debate in the United States about whether the current measures of health care quality are adequate to support the movement away from fee-for-service toward value-based payment. Some providers advocate slowing or even halting payment reform efforts because they don’t believe that quality can be adequately measured to determine fair payment. Employers and other purchasers, however, strongly support the currently available quality measures used in payment reform efforts to reward higher-performing providers. So far, the Trump administration has not weighed in.
