Medical errors and the quality of
healthcare are at the front of public and
regulatory scrutiny. First Opinion products
reduce diagnostic errors at the initial patient
encounter, providing a consistent and accurate
health assessment. This greatly improves patient
safety, reduces liability exposure, lowers
medical malpractice claims and reduces premiums.
Medical Errors
“Health care is not as safe
as it should be. A substantial body of evidence points
to medical errors as a leading cause of death and
injury.” 1999, Institute of Medicine.
So opened the Institution of Medicine’s 1999
report, To Err is Human by Lucian Leape, MD. Dr.
Leape’s report grabbed the attention of the
public and Congress; it sparked calls for reform
and stiffened popular suspicion of the medical
profession.
So,
what has happened since then? During his keynote
speech at the 2004 Annual Session of the
American College of Physicians, Dr. Leape
reported he has not seen a “big improvement” in
patient safety since the publication of his
report. How big is this problem? Some indicators
of the magnitude of the quality of care
deficiencies in American health care leading to
preventable injuries and deaths are evident in
the following insights:
• Medical error results in
as many as 400,000 deaths per year and as
many as 98,000 hospital deaths per year -
equivalent to one jumbo jet crashing daily.1
• Twenty five percent (25%) of hospital
deaths are preventable2
• Thirty percent (30%) of acute care
patients and twenty percent (20%) of chronically ill patients
receive care not indicated.3
Quality of Care
USA Today stated on August 5, 2004: “Five years
after the IOM report drew front-page headlines
and widespread outrage, there still is not even
a sure way to measure the problem. And that
appalling fact should concern any prospective
hospital patient -- which is to say, everyone.”
According to a 2004 national poll conducted by
the National Patient Safety Foundation:
- 42% of respondents either
personally or through a friend or relative
were affected by a medical error.
- 32% of respondents indicated
that the error had permanently damaged the
patient's health.
A recent RAND study further
confirms the problems with quality of care based
upon a study of 20,000 adults from 12 cities.
The study concludes that 45% of patients in
America do not receive the medical care
recommended by clinical experts and the most
current medical science.
Most of the efforts to
solve quality deficiencies leading to medical
errors have focused on medication errors.
Indeed, the costs of medication errors are high
in financial terms, when the estimate of the
cost for each preventable adverse drug event in
one teaching hospital is almost $4,700. However,
as the studies on overuse, underuse, and misuse
clearly demonstrate, and the Institute of
Medicine report emphatically states:
"the primary
source of medical errors and the greatest health
care quality challenge is the failure to
diagnose (approximately 21% of the medical
errors)."
Cost of Health Care - Preventable Injuries and Deaths
The total financial impact of the costs of
preventable medical injuries is $17 to $29
billion dollars, which includes costs in
addition to health care costs, such as lost
income, lost household production, and
disability. Over one half of these preventable
costs go exclusively toward health care costs.
This means that $8.5 to $14.5 billion dollars
are spent annually for additional health care
caused by preventable medical injuries. In 1996,
based upon these calculations, these figures
represented roughly 2% of total national health
care expenditures. Brought forward to the year
2002, with a total cost of $1.4 trillion
dollars, 2% for the additional costs of
preventable injuries translates to $28 billion
dollars annually.
A recent report developed by
the Midwest Business Group on Health, in
collaboration with the Juran Institute, asserts
that these errors “not only exact a human toil
in terms of lost lives and pain and suffering,
but they also create a huge economic burden in
terms of both the direct costs of treating
complications and the indirect costs of lost
productivity and premature death”. This study estimates that poor
quality health care costs the typical employer
between $1,700 and $2,000 per covered employee
each year.
First Opinion Solution
First Opinion Solution First Opinion
products’ approach to these problems is a focus
on clinical support tools aimed at reducing
diagnostic errors at the initial patient
encounter. These tools greatly improve patient
safety and reduce liability exposure.
First Opinion places the
accumulated knowledge of the medical community
at the fingertips of your staff – merely a few
mouse clicks away.
“The most important
approach (to preventing medical errors) is
to make better use of Information
Technology. A growing body of research
demonstrates that electronic health records
and associated decision-support technologies
reduce errors and costs. IT is not a
replacement for clinician knowledge and
thinking, but rather an assistant to
navigate the cognitive complexity of medical
practice.” The Oregonian,
Oct. 9, 2004.
1Committee
on Quality of Health Care in America,
Institute of Medicine, To Err is Human:
Building a Safer Health Care System (LT Kohn
et al., editors, 2000).
2Dubois, RW, Brook RH,
“Preventable Deaths: Who, How Often, and
Why?” Annals of Internal Medicine
109:582-589 (1988).
3National Quality Forum (Forum
for Health Care Quality Measurement and
Reporting), “A Call to Action,” at p. 2
(2001) available at www.qualityforum.org;
Institute of Medicine, supra note 5 at p. 1.
