Introduction
Errors are always costly. In fact, mistakes can cost a fortune. In clinical science, oversight doesn’t always translate into financial loss. Sometimes, accumulated missteps can lead to unwanted fatalities. In a paper published by Andel, Davidow, Hollander, & Moreno, “The Economics of Healthcare Quality and Medical Errors” (2012)[1], the cost of medical errors in the United States is about $19.5 billion. 87% of that goes to auxiliary expenditures such as ancillary services, prescription services, and inpatient/outpatient care. But despite efforts to rectify such negligence by spending an excessive amount of money, patient mortality still happen.
Errors in Medicine
Medical errors happen when a planned course of action doesn’t achieve its intended result. Errors can also occur when there is a deviation from the process that causes more harm to the patient. Medical mistakes can happen in one isolated case or in a whole system. According to the analytical paper published by Makary and Daniel, “Medical Error - The Third Leading Cause of Death in the US” (2016)[2], although unavoidable, human errors can be minimized by following three steps namely: making errors more visible so they can be intercepted, having remedies readily available to rescue patients, and following the principles that take human limitations into account.
Furthermore, they emphasized the importance of creating a culture of learning from past mistakes. By taking into consideration the steps mentioned earlier to minimize casualties due to clinical errors, the medical industry, in general, is getting closer to achieving a comprehensive learning health system.
What are Clinical Information Systems?
Not perfect but showed improvement. This is how Clinical Information Systems have been described in a study conducted by Islam, Poly, & Li (2018)[3]. Furthermore, the researchers pointed out how Clinical Information Systems helped minimize medical errors & unnecessary costs while dramatically improving the overall quality of the healthcare industry. Hence, making the workflow more efficient, convenient, and reliable.
In simple words, Clinical Information System (CIS) is a computer-based system that holds, records, and allows updates of patients’ data to support operational processes, policy making, and data management. A Clinical Information System can just be a local system in a healthcare facility or connected to a wide network of systems in different locations.
As also mentioned in the article from the Talking HealthTech website (2021)[4], some of the benefits of Clinical Information Systems are the automation of manual tasks, built-in error checking to increase accuracy and minimize human error, and record tracking.
According to the article published on the Biohealthmatics website (no date)[5], some notable advantages of adapting Clinical Information Systems are the convenience of access to medical records at all points of care, the ability to provide tools to help make timely and fact-based clinical decisions, and training and research through data mining. In short, acquiring a Clinical Information System seem beneficial to supply reliable data & minimize costly errors in healthcare facilities.
Clinical Information Systems Today
According to R.M. Gardner, the author of the published paper “Clinical Information Systems - From Yesterday to Tomorrow” (2016)[6], healthcare professionals as well as the clinical informaticians community can look at the current state of Clinical Information Systems as either a glass-half-full or half empty. Following his statement, Gardner further pointed out that there has been a significant increase in adapting such systems in the US. In fact, according to Gardner’s paper, the rate of adoption of CISs in the United States in 2014 went from 9% to 75%.
In spite of the rapid and surprising increase in utilization, Gardner (2016)[6] also noted the negative consequences of Clinical Information Systems. He emphasized that certifications in clinical informatics don’t guarantee optimized development and implementation of Clinical Information Systems from “programmers”. Hence paving the way to a new wave of errors called “unintended consequences” or UCs.
Unintended Consequences
As comprehensively stated in the studies conducted by Ash et. al., “The Unintended Consequences of Computerized Provider Order Entry: Findings From a Mixed Method Exploration” (2008)[7], reasons for these undesirable errors emanated from 9 issues that the researchers able to point out. These are additional workload, workflow issues, constant demands, paper persistence, communication issues, juxtaposition errors, modification in organizational structure, emotion, & overdependence.
To explore more, Ash et.al. (2008)[7] further stated that a large number of unintended consequences heavily influenced clinical decision support, 20% to be exact. As also investigated in another study conducted by Ash et. al.,” Some Unintended Consequences of Clinical Decision Support Systems” (2007)[8], although the integration of systems aims to improve efficiency and minimize preventable errors, the researchers found more types of concerns such as the difficulty of using computerized systems & alert fatigue.
Despite these disadvantages, as Gardner (2016)[6] also mentioned in his paper, no one wants to go back to the traditional but tedious pen and paper records. In one of his personal takes on the current status of Clinical Information Systems, it is looking bright for the next 25 years.
As Gardner (2016)[6] carefully explained in the same aforementioned study, the percentage of costly yet preventable medical errors is getting lower. Thanks to the help of systems such as Clinical Information Systems, Health IT-related cases are less than 1%. Furthermore, he cited 4 publications wherein he confidently said that health information systems are working and the number of healthcare leaders & organizations are growing.
Conclusion
Clinical Information Systems are tools to make the quality of workflow and clinical decisions of healthcare professionals better. By using this system, a lot of burdens were taken off of the shoulders of clinicians and now they can focus more on what they swore to do - improving the quality of life. Although Clinical Information Systems are far from perfect and need more exploration and innovation, it is proven to be an effective way to minimize costly errors that may result in unwanted casualties.
The errors of yesterday are the lessons for tomorrow.
References
- https://pubmed.ncbi.nlm.nih.gov/23155743/
- https://www.bmj.com/content/353/bmj.i2139.full
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115226/
- https://www.talkinghealthtech.com/glossary/clinical-information-system-cis
- https://www.biohealthmatics.com/technologies/clinical-information-systems/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171508/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2683676/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813668/
