Patient-care Net system sought

Asking health-care providers to work harder or be more careful won't eliminate most medical errors. What's needed are safer systems that make it "easy to do it right," according to a national report on patient safety released Thursday.

Strong, interconnected data systems must be created for that to happen, it says. The systems would not only save lives, but money.

The Institute of Medicine report, "Patient Safety, Achieving a New Standard of Care," is part of a continuing effort that grabbed national attention with the release in 1999 of the "To Err Is Human" report documenting unnecessary injuries and deaths in hospitals.

The report focuses on systemwide changes that can greatly reduce medical errors and improve patient outcomes. The report asks for creation of improved information and data systems to help make patient safety a standard of care. Those systems need to provide immediate access to complete patient information and decision-support, such as alerts and reminders. And they must capture information on patient safety, including "adverse events" and near misses, then use the information to design even safer systems.

Recommendations include building an information-technology infrastructure that would automate some information in health care, said Dr. Brent James, who served on the committee writing the report and is vice president for medical research and executive director of the Institute for Health Care Delivery Research at Intermountain Health Care. IHC and particularly LDS Hospital have been hailed for their work using protocols and data systems to improve patient safety.

To get a strong, workable infrastructure, the government must help with both funding and in setting standards. The report calls on Congress to provide "clear direction, enabling authority and financial support for the establishment of national standards for data that support patient safety."

The federal role would be similar, James said, to the initiative and cohesion it provided for what became the Internet. The goal is to deliver important information when critical treatment decisions are being made.

When such systems are available, physicians and institutions need to invest in and use them, according to the IOM panel.