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Analysis

How to Use Healthcare IT to Avoid Diagnostic and Medication Mix-Ups

By Christopher Cheney  
   July 31, 2018

Recommendations fall into three categories: communication, tracking, and acknowledgement of an information review and associated actions.

Healthcare IT has a key role to play in limiting diagnostic errors and botched medication changes, an ECRI Institute report says.

"Results can be—and often are—missed when the loop of receipt, acknowledgment, and action remains open. The resulting consequences stem from these now delayed, missed, and incorrect diagno­ses. A closed loop provides timely and effective therapies and mitigates diagnostic error," the report says.

Healthcare IT can help ensure that patient data requiring action is delivered to the right people at the right time in the right format, but the challenge can be daunting.

"Information throughout the healthcare delivery process is transmitted between entities such as laboratory, radiology, and pathology testing facilities, pharmacies, and other providers, all with a potential for interruptions of communication," the report says.

Diagnostic errors have negative impacts on patients and provider bottom lines.

A 2015 Institute of Medicine report, "Improving Diagnosis in Health Care," asserted that every American will experience a meaningful diagnostic error at some point in their lifetime.

On the financial front, diagnostic errors are responsible for about $34 billion in annual U.S. malpractice payments.

The ECRI Institute report's recommendations feature three categories: communication, tracking, and acknowledgement of an information review and associated actions.

The communication recommendations are designed to facilitate the efficient flow of information, with all diagnostic results and medications communicated to providers, pharmacists and patients on a timely basis:

  • Improve the flow of information using standards to format normal, critical, abnormal-noncritical, and abnormal results
     
  • Adopt standards for reporting of actionable findings to include results priority and timing of responses to diagnostic testing
     
  • Use universally recognizable display icons in the electronic health record for alerts and notifications
     
  • Enhance the usability of diagnostic results communications
     
  • Automate notification processes with existing EHR capabilities
     
  • Optimize alerts to improve notification and reduce alert fatigue
     
  • Avoid interruptions of diagnostic results communications
     
  • Provide diagnostic findings directly to patient

The report makes four tracking recommendations:

  • Seek opportunities where health IT can be used to correct deficiencies and improve monitoring
     
  • Create accountability for oversight of tracking
     
  • Adopt laboratory standards that improve tracking
     
  • Establish bi-directional communication between hospital computer systems and third-party systems such as laboratory partners. Bi-directional capability eases the ordering and reporting of laboratory, radiology, pathology, and diagnostic results.

The report makes two recommendations use health IT to acknowl­edge the review of information and document the action taken:

  • Use health IT to link and store an acknowledgment and to record the action taken
     
  • Develop the capability to commu­nicate actions taken along with acknowledgments or instead of them. For example, diagnostic-results notification mes­sages should be modifiable by the recipient to add the action taken to "close the loop" such as read, acknowledged or patient notified.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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