Wednesday’s Wall Street Journal (November 15, 2006, p. D3) had a fascinating report on the impact of physicians’ offices on patient safety. The sidebar tells the story:
These are bad outcomes that could be prevented if physicians had the information they need at the time of the office visit. There has been a lot of attention to hospital safety (Leapfrog Group at http://www.leapfroggroup.org/ and National Institutes of Medicine’s To Err is Human at http://www.iom.edu/?id=12735), but this article makes the compelling argument that physicians’ offices are a big problem, too.
The story is familiar – there are few systems in place to assure quality at the level of the office practice. Have you ever heard, “We can’t find your chart?” How about, “Test result? What test result?” Or, “I guess we shouldn’t have prescribed that medication”? Basically, there’s a lot of information that should be available at the time of an office visit that just isn’t there. And because it is not, mistakes are made. Reasons include the paper-based medical record: remember you old savings account passbook? Think we could have today’s financial system if someone still had to sign your passbook for every transaction? But other causes also include the lack of timely attention to known problems and the lack of coordination with pharmacy records for side effects and drug interactions.
In most practices, the physician picks up your chart on the way into your examining room, flips through it to see notes from the last visit or any lab studies, and sees you with less than 60 seconds preparation. That wouldn’t be a problem if there were a really good system that presented the important information that she needed to know, that monitored what preventive care you should be receiving and alerted her, and especially one that highlighted the information that is missing. Part of the answer will be an electronic medical record, but it will not be enough just to put the current mistakes and shortcomings online.
We can do better.
Recent Comments