Every year, more than 250,000 people in the United States die from medical errors, and to put that into perspective, that would be the third-leading cause of death after heart disease and cancer. This number may actually be higher, as medical errors are rarely noted on death certificates. While some may blame physicians and other medical professionals for the abundance of medical errors, many researchers believe that systemic issues are actually the root cause of the problem.
Medical errors are described as, "a preventable adverse effect of medical care, whether or not it is evident or harmful to the patient." These include, misdiagnosis, improper treatment, incorrect drug dosage or type of drug, wrong-site surgery, falls, burns, and more. But why do these errors happen? According to the Medical Malpractice Liability in the Age of Electronic Health Records, the three main reasons for medical errors include inadequate training, errors in medical data or communication, and systemwide bugs in the technology. Often times, information is not well documented, leading to errors when a patient is transferred to a different hospital, and the lack of information can influence diagnostic or prescription decisions. Inconsistent training can also play a role in medical errors. In fact, previously, many states did not require certifications for pharmacy technicians, even though they were responsible for administering nearly all IV medications. Human errors, such as misreading a label or failing to properly follow certain procedures, are also another cause of medical errors that can be heightened by insufficient staffing. Some may wonder, "Why don't hospitals just implement stricter procedures and checklists?" However, Dr. Danielle Ofri states, "The problem is, once you have a million checklists, how do you get your work done as an average nurse or doctor? ... They just get in the way of getting through your day. And so we just check all the boxes to get rid of it." In laboratory settings, many procedures are often standarized to prevent errors in the data, but healthcare workers are faced with urgent and time-sensitive situations. While most healthcare workers are hardworking and passionate people, human errors can arise, and this can have a drastic impact on the life of a patient.
Computerized physician order entry (CPOE) helps check for missing information on an order!
Yet, new emerging technology is revolutionizing the healthcare system, including the occurence of medical errors. In the US, it is estimated that medication errors harm at least 1.5 million patients a year, and 20% of all medical procedures, including prescription of medications, may be unnecessary. However, scientists have proposed a solution to this issue, which uses IT systems to create an electronic medication management system, which will help reduce errors in prescription, transcription, dispensing, and administration, since current systems rely on a healthcare worker's memory of large amounts of information, and the human memory is prone to mistakes. Many other technological tools can be used to avoid medication errors, including a bar-coded medication administration system (BCMA), which is a system that allows the healthcare provider to scan a patient's wristband and medication to check that it is the correct medication, and computerized physician order entry (CPOE), which aids in prescribing the medication by providing information and checking for issues such as drug interference or missing information. According to Dr. David Classen, an associate professor of medicine at the University of Utah, "Any tools that enable patients to manage their health-care needs will be a game changer." Other apps, such as one directed towards patients, provides information about certain drugs and prescriptions, so patients will be more informed about the usage and possible side-effects of a drug. These advancements in technology have reduced errors in healthcare, but it is still important for healthcare workers and hospitals to report and fix errors to improve the system.
However, technology bugs and glitches can be the source of medical errors, as Dr. Danielle Ofri highlights in her interview with National Public Radio (NPR), "But of course, I'm not thinking about the billing diagnosis. I want to think about the diabetes. But this gets in the way of my train of thought. And it distracts me. And so I lose what I'm doing if I have to attend to these many things," showing that electronic health records can be distracting and confusing, leading to miscommunication. Another error caused by electronic health records includes a case where the physician did not check for an abnormal urinalysis in the patient's records, which caused the patient to get advanced kidney disease. Other issues, such as technology defects and freak accidents can occur, but most medical errors are due to communication issues, computer interface, and clinical content.
As a patient, it is important to take action to protect yourself from medical errors. According to Patient Safety America, an organization dedicated to informing patients about the truth about healthcare, states that, "There are three levels on which you can begin to protect yourself: 1) be a wise consumer of healthcare – demand quality, cost-effective care for yourself and those you love, 2) participate in patient safety leadership through boards, panels and commissions that implement policy and laws, and 3) sponsor and work for laws that favor safer care, transparency and accountability." Patients can protect themselves from medical errors by asking questions about the condition, medication, or procedure, and when in doubt, seek a second opinion. Bring close friends or family can also help, as they can support you and ask questions. For example, during a trip to the doctor's office, the nurse said that I needed a second dose of the Hepatitis A vaccine. However, my mom noticed that the date the nurse said I got the vaccine didn't seem correct, and she remembered that I had already gotten the vaccine. She asked the nurse, and it turns out that when they checked my medical records, I had already gotten both doses of the Hepatitis A vaccine. Asking prevented me from getting an extra dose of the vaccine, so as a patient, it is important to be vigilant about your health, since healthcare workers are human and prone to mistakes too. In addition, it can be helpful to write down important information, such as allergies, and questions before you go to the doctor, so you won't forget to inform doctors about an issue or forget to ask a question. It's important to stay informed on the medications and procedures, so it's your right to ask doctors for any information regarding your health.
While medical errors are a huge problem worldwide, patients can do their part in preventing medical errors by asking doctors for information and checking the information and medications. Emerging technology is also helping hospitals prevent medical errors, but despite this, medical errors can still occur, often due to miscommunication between doctors, patients, and other healthcare workers. Together, healthcare workers and the public can work together to create a safer future for all.
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