Health IT, Hospitals

Leapfrog Group CEO: Health IT systems still can be dangerous

“For us humble patients, good stewardship of the technology is about as mundane as life and death,” Leapfrog Group CEO Leah Binder cautioned in a Wall Street Journal commentary.

Lest anyone forget, health IT systems can be dangerous, even deadly.

“Our tax dollars are paying for federal investment in health-care clinical systems, but little of that money requires hospitals to prove the systems are safe,” Leah Binder president and CEO of the Leapfrog Group, wrote on the Wall Street Journal’s “The Experts” blog

“Perhaps that sounds boring compared with the wiz-bang breakthroughs promoted in the booming IT marketplace. But for us humble patients, good stewardship of the technology is about as mundane as life and death,” Binder cautioned.

A key part of the problem is that sometimes inexperienced administrators wrongly “expect technology to somehow electronically solve complex human and managerial issues,” according to Binder. In other words, they still, despite years of warnings otherwise, do not when implementing IT address underlying processes that can cause patient harm.

“This management problem is very serious, at the roots of widespread dissatisfaction—sometimes outright revolt—from physicians, nurses and other clinicians who are not happy when their hospitals convert to digital solutions. They are often deeply frustrated with ham-handed implementation that makes their jobs harder,” Binder said.

In one example she gave, a friend named Ralph, who had experience implementing electronic health records, started a new job. It was a disaster from the start:

On his first day on the job, the IT vendor sent Ralph a timeline and project plan for installing the new system. By remarkable “coincidence,” that project plan aligned perfectly with the timing of the vendor’s billing cycles. “From experience, I know it would have been a complete failure to use this vendor’s plan, which was developed for the vendor’s convenience, not ours,” Ralph told me. “For instance, it had nothing built in for educating and building support among physicians—and without that you are basically dead in the water. But a lot of hospital leaders just don’t realize what’s truly involved in installing these new clinical systems and they figure the vendor knows best. Big mistake.”

Binder also discussed the tests run by Leapfrog, a Washington-based organization that rates healthcare providers on safety measures on behalf of large employers who purchase healthcare for their employees. Of note, computerized physician order entry systems have some serious shortfalls.

“[W]e find that a third of the orders tested in the IT systems of over 1,000 hospitals each year don’t properly alert to errors. Worse, one in six of the orders we test that would have killed the patients don’t get stopped by the systems,” Binder wrote.