US Physicians Sceptical IT Can Cut Medical Errors

A new US study has highlighted a major gap between the strategies recommended by medical error experts to reduce errors, and the views of physicians and members of the public.

Relatively few US physicians identified increased use of IT as a very effective part of strategies to reduce medical errors in hospitals.

Keynote studies, such as the 1999 Institute of Medicine report on strategies for reducing medical errors, have identified increased use of computerised medical records and using electronic ordering of medical tests and drugs as effective ways of reducing errors.

The 2000 Institute of Medicine report, To Err Is Human, concluded that each year more Americans die as a result of medical errors made in hospitals than as a result of injuries from care accidents.

However, the study found that both physicians and members public believe that the numbers of in-hospital medical deaths resulting from errors is much lower than that suggested by IOM and also believe that a substantial proportion of these deaths are not preventable.

The new study, published in the December 12 issue of the New England Journal of Medicine, also shows that physicians and members of the public also do not necessarily agree with strategies recommended by national organisations.

Increased use of computerised records and electronic prescribing has been a key recommendation of the IOM in reducing errors. However, only 19% of physicians said that increased use of computerised medical records would be very effective in reducing errors. This compares with 46% of members of the public.

A similar gap was found on the use of computers for ordering medical tests and drugs, with 23% of physicians saying they thought it would very effective in reducing errors, compared to 46% of members of the public questioned.

Physicians saw just two proposals as being very effective in reducing medical errors: requiring hospitals to develop systems to reduce medical errors (55%) and increasing the number of hospital nurses (51%).

The top four causes of medical errors identified by members of the public were physicians not having enough time with patients (72%); overwork, stress or fatigue on the part of health professionals (70%); failure of health professionals to work together or communicate as a team (67%); and understaffing of nurses in hospitals (65%).

Overall some 42% of the public and more than one-third of US doctors said that they or their family members have experienced medical error in the course of receiving medical care, according to the survey by Harvard School of Public Health and the Henry J. Kaiser Family Foundation.

Both doctors and the public agreed that as many as half of the deaths due to medical errors could have been prevented, but neither group listed medical errors among the top "problem facing health care and medicine in the country today." Only 5% of physicians and 6% of the public identified medical errors as a top concern.

The researchers conclude that neither physicians nor the public has the sense of urgency expressed by national organisations, such as the Institute of Medicine, to reduce medical errors. "To advance their agenda, national groups need to convince physicians, in particular, that the current proposals for reducing errors will be effective."