Measuring and improving patient safety through health information technology: The Health IT Safety Framework
This is a review of Hardeep Singh and Dean Sittig's "Measuring and improving patient safety through health information technology: The Health IT Safety Framework." [1]
Contents
Introduction
Despite rapid adoption and use of health information technology (HIT or health IT) with the potential to improve patient safety outcomes, there is still no clear way to measure the impact of this technology on these outcomes. The health IT safety framework was created to contextualize "health IT-related patient safety measurement, monitoring, and improvement." [1]
Framework Rationale
Most organizations have not been focusing on health IT-related patient safety as they race to implement systems that meet meaningful use (MU) criteria. This framework will help put measurement of health IT-related patient safety at the forefront of an organization's existing patient safety efforts, which will be essential as use of HIT continues to flourish. The 3 essential elements this framework addresses are:
"1. refine the science of measuring health IT-related patient safety 2. make health IT-related patient safety an organizational priority by securing commitment from organizational leadership and refocusing the organization's clinical governance structure to facilitate measurement and monitoring 3. develop an environment that is conducive to detecting, fixing and learning from system vulnerabilities." [1]
Overview of Framework
Follows principles of "continuous quality improvement."
Sociotechnical Work System
The Sociotechnical Work System is comprised of 8 components:
- Hardware and software
- Clinical content
- Human-Computer interface
- People
- Workflow and communication
- Internal organizational features
- External rules and regulations
- Measurement and monitoring
The HITS Framework presupposes that patient safety events must be considered in the context of these 8 sociotechnical domains.
Measurement of three overlapping domains of HITS
In addition to the sociotechnical system, there are 3 domains of health IT implementation and use:
- Safe health IT
- Safe use of health IT
- Using health IT to improve safety
Measurement must occur in all 3 domains, both retrospectively and proactively in order to learn from past events and prevent those that could occur in the future.
Measures should be impactful, scientifically acceptable, feasible, usable, and transparent.
Expected Measurement Impact
Diverse stakeholders must come together to improve measurement of safety concerns related to or able to be determined via effective use of health IT. Organizations must continue to learn from the data these measures generate and must take a "360-degree approach" to analyzing and reacting to said data. If an organization prioritizes these efforts, they will develop a culture of health IT-related patient safety and will be able to learn how to improve safety of their HIT systems.
Use of the Framework to Overcome Challenges of Real-World Measurement
Facilitate organizational preparedness
Advance Current Measurement Methods
Identify top priorities for measure development
Comments
References
- ↑ 1.0 1.1 1.2 Hardeep Singh and Dean F. Sittig. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Qual Saf. Published online first 2015 September. http://www.ncbi.nlm.nih.gov/pubmed/26369894?dopt=Abstract