The King of Pop is dead. It’s been two years now since the death of pop superstar and music icon, Michael Jackson…Tragically, a death from an overdose of drugs. His personal physician, Dr. Conrad Murray, has been on trial for involuntary manslaughter, i.e. murder caused by a serious medical error on Dr. Murray’s part.
Could an electronic health record have prevented Dr. Murray’s fatal mistake?
In 1999, the Institute of Medicine (IOM) issued a report entitled “to Err Is Human.” The shocking revelation in this report was that 98,000 people die annually as the result of preventable medical errors. One Public Health News Articles 2019 study by Dr. David Bates indicated that the use of health information technology could reduce drug errors by 55%. In another study, Dr. Bates’ research team saw a reduction of drug errors by a whopping 88%.
Physician: Pharmacist Courses Do No Harm
Legend has it that doctors must swear to the Hippocratic Oath in general, and to the phrase “First, do no harm,” in particular. What the Hippocratic Oath actually says is that the physician “will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.” Moreover, it adds a phrase that Michael Jackson’s doctor should have heeded: “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan”
Patient Safety and Quality Health Care – a national priority
The formation of the Leapfrog Group is evidence that corporate America is concerned with the quality of healthcare. The Leapfrog Group is a conglomeration of Fortune 500 companies. A major concern for the Leapfrog companies was the prevention of adverse drug events. Their goal was to use their massive purchasing power to “encourage” hospitals to adopt Computerized Provider Order Entry (CPOE) systems – which is analogous to electronic prescriptions or e-prescribing at the ambulatory physician setting. CPOE is another core requirement for qualifying for the meaningful use electronic health record incentive payments.
In 2004, President George W. Bush explained his vision for electronic health records in the United States by 2014. The electronic health record goal was to prevent medical errors, mistakes and deaths due to physicians making uninformed decisions. In 2009 President Barack Obama, included the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the stimulus bill. The HITECH Act stipulated the adoption of electronic health records and the exchange of data between medical entities. But it also provided incentive money to physicians and hospitals that adopt electronic health records and use them in a meaningful way.
What’s Meaningful Use?
Hospital bar code enabled medication administration systems can verify that the right drug was Hospital bar code enabled medication administration systems demonstrate the meaningful use concept. Those systems can verify that the right drug was given to the right patient in the right dose at the right time. But the government and the HITECH Act goes further. $19.2 billion has been allocated for incentives for electronic health record adoption. The Centers for Medicare & Medicaid Services (CMS) has specific criteria that medical providers (both physicians and hospitals) must meet in order to qualify for the annual EHR incentive money. Several of the incentive measures have to do with drugs:
drug-to-drug allergy checks
active medication list
active medication allergy list
e-prescribing (electronic prescriptions).
According to the coroner, Michael died from “acute propofol intoxication.” In other words, an overdose of the medication. Who knows if an electronic health record system would have prevented Michael Jackson’s death. But EHRs have the potential to increase patient safety and improve the quality of healthcare in the United States.