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CHIME weighs in on federal health IT safety plan

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ANN ARBOR, MI, February 5, 2013 – In comments submitted to the Office of the National Coordinator for Health Information Technology (ONC) yesterday, the College of Healthcare Information Management Executives (CHIME) largely supported the agency’s plans to play a coordinating role in support of health IT safety.

Responding to ONC’s Patient Safety Action & Surveillance Plan, CHIME agreed with the proposed approach to leverage existing policy levers and programs within HHS, rather than create another federal entity to enhance health IT safety.

“CHIME applauds ONC’s efforts to conceptualize its Patient Safety Plan within existing policy mechanisms and programs,” the organization of healthcare CIOs said.  “In particular, we support the notion that pre-existing patient safety efforts across government programs and the private sector – including those sponsored by providers, vendors and healthcare safety oversight bodies – be used as foundational leverage to strengthen health IT and patient safety.”

While CHIME urged the involvement of ONC in designing a framework to use health IT to make care safer and continuously improve the safety of health IT, the group suggested that implementation of the patient safety plan should rely on a stakeholder-driven organization that included federal partners, but was not under the direct control of federal agencies.

CHIME urged the use of “voluntary consensus bodies” – organizations developed to identify and improve existing standards and guidelines for use within the government – to facilitate agreement among healthcare stakeholders on a recognized set of standards and guidelines for patient safety in health IT.

“We believe such an organization could then be buttressed by an enhanced network of patient safety organizations (PSOs) that could leverage appropriately aggregated reports to encourage continuous learning,” CHIME said.

CHIME also supported the acknowledgement by ONC that, “the accurate and efficient matching of patients to their health information is critical to ensuring patient safety.”  CHIME urged a more focused effort to address patient data-matching, saying that, “despite years of development, no clear strategy has emerged to accurately and consistently match patient data.  The results of a 2012 CHIME survey suggest that now, more than ever, action is needed to ensure the right data is matched with the right patient.  Unintended injury or illness attributable to patient data-matching error is a considerable, and growing, problem in this era of health information exchange.  And with a substantial portion of CIOs involved with HIEs that use differing approaches to data matching, we can expect the inconsistency and variability inherent to healthcare IT systems to persist – and become more endemic – without national leadership and consistent standards.”

Finally, CHIME strongly urged that attention be paid to how much time and resources are expected of providers to report on safety events.  While the group supported the need for more information on patient safety events and believed the general approach ONC is suggesting (through AHRQ Common Framework and PSOs) is reasonable, CHIME said there is a significant danger in developing a reporting regime that unduly burdens providers.

“CHIME recommends that ONC work with stakeholders to determine ways that reports can be compiled once and used many times.  We believe there needs to be a scaleable approach that spans federal, state and private-sector reporting requirements.  We want to make sure that health information is managed in a way that avoids duplicative reports to various entities and disparate data silos do not impede the learning health system that is needed to understand how health IT and patient safety interrelate.”

The full text of CHIME’s letter to ONC can be found at http://www.cio-chime.org/advocacy/resources/download/CHIME_Response_ONC_Patient_Safety_Plan_Final.pdf.  


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