Morgan Matthew W
Medical Informatics, Misys Healthcare Systems, University of Toronto, Ontario, Canada.
Healthc Pap. 2004;5(3):10-26. doi: 10.12927/hcpap.2004.16860.
This paper provides evidence that Canada's healthcare system is not as safe as it needs to be, and suggests ways to make it safer. Healthcare leaders must recognize that patient safety is indistinguishable from the delivery of high quality, affordable healthcare, and they must become more knowledgeable about the extent of the patient safety problem in Canada. The creation of a Patient Safety Board, modelled after Canada's Transportation Safety Board, will provide the authority healthcare leaders require to reduce medical errors. Without a national Patient Safety Board we cannot efficiently and effectively identify, quantify and address medical errors in Canada. This paper also urges healthcare leaders to recognize that a fundamental tool in improving patient safety is the electronic health record (EHR). Return on investment data for a national EHR strategy are presented. The author focuses on three EHR initiatives: outpatient electronic prescribing; in-patient computerized physician order entry; and home-based diabetes disease management. Potential net savings to Canada from these three EHR initiatives alone approach $2 billion annually. We must accelerate our EHR investment. Coordinated national EHR initiatives will cost less, save lives and prevent harm when compared to the status quo. These initiatives will also provide the foundation for transforming our healthcare system and will assist in building a better-educated, healthier and therefore more economically competitive nation.
本文提供的证据表明,加拿大的医疗保健系统并不像其应有的那样安全,并提出了使其更安全的方法。医疗保健领域的领导者必须认识到,患者安全与高质量、可负担得起的医疗保健服务的提供密不可分,他们必须更加了解加拿大患者安全问题的严重程度。仿照加拿大运输安全委员会设立一个患者安全委员会,将为医疗保健领域的领导者提供减少医疗差错所需的权力。没有一个全国性的患者安全委员会,我们就无法有效且高效地识别、量化并解决加拿大的医疗差错问题。本文还敦促医疗保健领域的领导者认识到,改善患者安全的一个基本工具是电子健康记录(EHR)。文中展示了一项全国电子健康记录战略的投资回报率数据。作者重点关注三项电子健康记录计划:门诊电子处方;住院医师医嘱电子化录入;以及基于家庭的糖尿病疾病管理。仅这三项电子健康记录计划每年就能为加拿大带来近20亿美元的潜在净节省。我们必须加快电子健康记录方面的投资。与现状相比,协调一致的全国电子健康记录计划成本更低、能挽救生命并预防伤害。这些计划还将为变革我们的医疗保健系统奠定基础,并有助于建设一个教育水平更高、更健康、因而在经济上更具竞争力的国家。