Death by medical error (DME) is an issue which originally was reported to claim 98,000 lives per year in 1999. DME has recently been reported to likely be closer to 200,000 deaths per year in 2009. The challenge is daunting as it is the result of multiple factors many of which are result of human error. The report below makes clear that accurate reporting and accountability are particularly troublesome. It also calls into question the professional, business, and legal factors which negatively impact the ethical environment which health care takes place.
Death by medical error is a pressing medical issue that needs the attention of the current and next generation of engineers. Unfortunately as can be seen it has been less tractable to leading edge technology than most medical issues. The reasons are multifold ranging from CYA at the medical professional level to business strategies by health care IT industry of creating proprietary products and health care record systems that do not play well with the competition. The multi headed hydra of DME is not the type of challenge that our research institutions or healthcare corporations can address well independently. Simply put the DME problem is not as glamorous as “leading edge” research like tissue interface research, genetic engineering, systems physiology, etc. The answers in this area will not likely come from innovative technical breakthrough but from grinding detail work. Moreover, health care IT corporations look at the problem from a “how can I make money from this” point of view. Essentially the issue has been and continues to be corporations insisting on products that will provide improved patient care while producing a high margin and freezing out the competition to carve out markets “for the stockholders benefit”. While these institutions nibble at the edges of the problem death by medical error continues to claim lives.
So what can be done? Two general approaches are being used. The first is the creation of set of national standards to communicate, document, organize and analyze a patient’s medical record. The current federal level thrust to create a nationally compliant electronic medical record system is making headway in that direction. A number of corporations have signed on to standardization and have certified their products. Second is a set of real time health care data management tools that use the patient EMR data to reduce human error to an absolute minimum. A number of methods are being used which use bar codes and RFID’s to keep track of drugs, patients and their interaction. More in depth research to determine the best of breed approaches is needed.
The safety of the patient relies on medical professionals to execute patient safety rules consistently. In the final analysis a user friendly patient management system that helps these professionals apply those rules consistently will help drive DME to a minimum.