Efforts to establish a nonregulatory, public-private partnership focused on patient safety and health IT are still in the works, said Andrew Gettinger, MD, the Office of the National Coordinator for Health IT's CMIO and acting director of the Office of Clinical Quality and Safety, speaking at the federal Health IT Joint Committee meeting on Jan. 20.
While the collaborative is still a proposal, ONC is "trying to incrementally advance the consideration of safety in software design and development,” said Gettinger. However, he said any clinician who has used such software knows that’s not enough. “We need to look beyond the certification program to total quality management, how institutions choose to implement EHRs and how clinical users take the responsibility to learn how to operate it safely.”
Before anyone can comment on safety, Gettinger noted, “we have to be able to measure.” His team has partnered with the National Quality Foundation (NQF) which is prioritizing and identifying patient safety measures to form a baseline.
Since the interoperability roadmap was released last summer, Gettinger said he has not been working to implement the collaborative but to test some of the hypotheses brought forward by the roadmap task force. They’ve identified medication management and convened a group to acquire research evidence.
Depending on the outcome, they expect to disseminate the evidence and potentially additional tools and guides. They could learn that some institutions do this really well already and so would try to disseminate their tools and resources more broadly, he said. “I’ve been impressed at how much content we have and how little it’s been disseminated and understood by the broader community.”
Gettinger also discussed several private-sector initiatives, from The ECRI Institute’s patient safety workgroups, to the just announced national patient identification challenge from CHIME. Medstar and the American Medical Association have partnered on the EHR User-Centered Design Evaluation Framework and the Pew Foundation is engaged in health IT relative to implantable devices. “The federal government is not able to do all of this work on its own but we support and acknowledge the important work done in the private sector.”
Gettinger also talked about the importance of not putting any further burdens on clinicians when it comes to reporting. “It’s up to us, the broader community, to go down the road to better relate evidence of quality and safety that won’t require burdensome reporting.”
While it’s hard to come up with measures that don’t require some engagement, “we’re committed to doing that,” he said. His team is collaborating with other folks in that space such as the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality and NQF. “We’re looking to streamline the process.”
On the safety side, there is a proposed collaborative that will have statutory protections, the same kind of protections for developers that currently providers and hospitals have relative to the discovery of safety processes. He seeks sharing between the stakeholders with deference to the intellectual property rights each company holds. There are other methodologies such as incorporating patient pictures into health records. “There are a number of thing emerging that I think are quite exciting.”