University of Texas - Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Science Center at Houston, TX, United States.
MaineHealth, Portland, ME, United States.
Healthc (Amst). 2018 Mar;6(1):7-12. doi: 10.1016/j.hjdsi.2017.06.004. Epub 2017 Jul 15.
In 2011, an Institute of Medicine report on health information technology (IT) and patient safety highlighted that building health-IT for safer use is a shared responsibility between key stakeholders including: "vendors, care providers, healthcare organizations, health-IT departments, and public and private agencies". Use of electronic health records (EHRs) involves all these stakeholders, but they often have conflicting priorities and requirements. Since 2011, the concept of shared responsibility has gained little traction and EHR developers and users continue to attribute the substantial, long list of problems to each other. In this article, we discuss how these key stakeholders have complementary roles in improving EHR safety and must share responsibility to improve the current state of EHR use. We use real-world safety examples and outline a comprehensive shared responsibility approach to help guide development of future rules, regulations, and standards for EHR usability, interoperability and security as outlined in the 21st Century Cures Act. This approach clearly defines the responsibilities of each party and helps create appropriate measures for success. National and international policymakers must facilitate the local organizational and socio-political climate to stimulate the adoption of shared responsibility principles. When all major stakeholders are sharing responsibility, we will be more likely to usher in a new age of progress and innovation related to health IT.
2011 年,医学研究所关于医疗信息技术(IT)和患者安全的报告强调,构建更安全的医疗信息技术是供应商、医疗服务提供者、医疗机构、医疗信息技术部门以及公共和私营机构等主要利益相关者的共同责任。电子健康记录(EHRs)的使用涉及所有这些利益相关者,但他们往往有冲突的优先事项和要求。自 2011 年以来,共同责任的概念几乎没有得到重视,EHR 开发人员和用户继续将大量长期存在的问题归咎于对方。在本文中,我们讨论了这些主要利益相关者在改善 EHR 安全方面的互补作用,并且必须共同承担责任,以改善当前 EHR 使用的状况。我们使用真实的安全示例,并概述了一种全面的共同责任方法,以帮助指导 21 世纪治愈法案中概述的 EHR 可用性、互操作性和安全性的未来规则、法规和标准的制定。这种方法明确界定了各方的责任,并有助于为成功制定适当的措施。国家和国际政策制定者必须促进当地的组织和社会政治环境,以激发共同责任原则的采用。当所有主要利益相关者都在共同承担责任时,我们将更有可能迎来与医疗信息技术相关的进步和创新的新时代。