The National Academies Press

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1 Introduction
Pages 15-30

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From page 15... ... Early work found evidence-based practice is only followed 55 percent of the time (McGlynn et al., 2003) , and ensuing studies have reconfirmed that medical errors continue to be prevalent, as more than 1.5 million preventable adverse drug events occur annually (IOM, 2006) Read the entire page →
From page 16... ... This background is needed to understand the context for discussing patient safety related to health information technology (health IT) .2 PATIENT SAFETY More than 10 years since these landmark patient safety reports, there is considerable controversy about how much improvement in safety has actually occurred. Read the entire page →
From page 17... ... To Err Is Human recognized that more patients could be harmed by errors in ambulatory settings because more medical care is delivered outside of hospitals than inside. A recent review of malpractice claims concluded that 52 percent of all paid malpractice claims for all physician services involved ambulatory services, and almost two-thirds of these claims involved a major injury or death (Bishop et al., 2011) Read the entire page →
From page 18... ... Clinicians expect health IT to support delivery of high-quality care in several ways, including storing comprehensive health data, providing clinical decision support, facilitating communication, engaging patients, and reducing medical errors. In the near future, it is likely that patients, particularly those with chronic illnesses, will consistently use the Internet to track their own health through personal health records and handheld device applications. Read the entire page →
From page 19... ... (2010) ; CDC/NCHS, National Ambulatory Medical Care Survey. Read the entire page →
From page 20... ... government has invested and will continue to invest billions of dollars toward the meaningful use of effective health IT in the hopes of improving the quality of care, decreasing the cost of care through improved efficiency, and guiding clinicians to choose the most effective care interventions. In 2004, the Office of the National Coordinator for Health Information Technology (ONC) Read the entire page →
From page 21... ... The promise of these movements to reduce costs and improve patient outcomes assumes that high-quality patient data can be shared reliably and effectively among providers. These movements, among others, are likely to influence the speed of adoption and broaden the functions of health IT considerably (NCVHS, 2001) Read the entire page →
From page 22... ... But the evidence of health IT's impact on patient safety beyond medication safety and across the health care system is lacking. Although evidence suggests improvements in safety can be made, some studies have found health IT to have no effect on patient safety, and case reports such as those cited above show that it can also contribute to harm. Read the entire page →
From page 23... ... Health IT–assisted care includes care supported by and involving EHRs, clinical decision support, computer ized provider order entry, health information exchange, patient engage ment technologies, and other health information technology used in clinical care. The committee will (1) Read the entire page →
From page 24... ... These are critical for the ONC to address in order to achieve its mission of having widespread use of EHRs by 2014. Similarly, the validity and use of information from common Internet sites applied to specific patient situations during delivery of care is also important in the changing health care delivery environment but was not considered in the scope of this report. Read the entire page →
From page 25... ... However, when asked about the volume and types of adverse events related to their EHR products, vendor responses ranged from 0 to 40 events per year, although none provided a full list of problematic events and potential patient safety concerns (IOM, 2011) Read the entire page →
From page 26... ... The report reflected its time with a focus upon the record as used in medical environments, but not solely for medicine or medical care in the narrowest sense. It set a vision for nationwide computer-based patient records and called for electronic records to be standard in care delivery and detailed primary and secondary uses of electronic records (IOM, 1991) Read the entire page →
From page 27... ... . It identified eight key functionalities for EHR systems: health information and data, results management, order entry management, decision support, electronic communication and connectivity, patient support, administrative processes, and reporting and population health management. Read the entire page →
From page 28... ... 2011. Paid malpractice claims for adverse events in inpatient and outpatient settings. Read the entire page →
From page 29... ... 2010. Electronic medical record/electronic health record systems of office-based physicians: United States, 2009, and preliminary 2010 state estimates. Read the entire page →
From page 30... ... 2010. Realizing the full potential of health information technology to improve healthcare for Americans: The path forward. Read the entire page →

From page 15...

... Early work found evidence-based practice is only followed 55 percent of the time (McGlynn et al., 2003) , and ensuing studies have reconfirmed that medical errors continue to be prevalent, as more than 1.5 million preventable adverse drug events occur annually (IOM, 2006)

1 Introduction Pages 15-30

1 Introduction
Pages 15-30