Framework for patient care through robust IT

If we are to significantly improve the quality, safety and cost-effectiveness of healthcare in our nation, we must employ the power of health information technology (IT). New delivery and payment models that demonstrate improvements in cost and quality require robust IT to succeed. This includes electronic health records, clinical decision support and other software that is designed to inform clinical decision-making. Now, a new set of principles, created with bipartisan and broad stakeholder support, promises to help guide health IT development and use in ways that promote patient safety. 

Health IT has always had strong support from both parties. Building upon numerous legislative proposals with bipartisan support over the last decade, the Health Information Technology for Economic and Clinical Health (HITECH) Act brought about new authorities, an increased focus on standards and significant investments in health IT. As a result of considerable public- and private-sector action, the number of clinicians, hospitals and other providers who have adopted health IT to improve the quality, safety and efficiency of care has significantly increased.  

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New policies are being developed by the Department of Health and Human Services (HHS) to support the use of IT to make healthcare safer and to continually improve the safety of health IT. This past December, HHS released a draft Health IT Patient Safety Action and Surveillance Plan for public comment, following the release of the Institute of Medicine’s HHS-commissioned report, Health IT and Patient Safety: Building Safer Systems for Better Care. In response to the Food and Drug Administration Safety and Innovation Act of 2012, over the coming months, HHS will develop a strategy and recommendations for an appropriate, risk-based regulatory framework for health IT. 

As co-chairmen of the Bipartisan Policy Center’s Health Project, our mission is to enable public- and private-sector leaders to develop workable, bipartisan solutions that address current challenges in the U.S. healthcare system. Over the last four months, the Bipartisan Policy Center has engaged a wide range of experts and stakeholders to develop a set of principles and recommendations for an oversight framework for health IT. The results of this work will be released Feb. 13.

We believe that promoting patient safety in health IT requires national focus and public- and private-sector leadership, collaboration and commitment. Any oversight framework for patient safety in health IT must reflect the following principles. First, it must recognize and support the important role that health IT plays to improve the quality and safety of care. Second, it should be risk-based, flexible enough to accommodate a rapidly changing healthcare system, and promote — not stifle — innovation. Third, it should leverage existing safety and quality-related authorities, processes and standards. Fourth, reporting within a non-punitive environment is essential to facilitate learning and improvement. Finally, assuring patient safety is a shared responsibility that must involve the entire healthcare system, including those who develop, implement and use health IT to support better health and healthcare. 

Building upon these principles, the Bipartisan Policy Center developed an oversight framework that contains the following key elements: accountability through agreement on and adherence to recognized standards; support for implementation through education and training; and the creation of a learning environment that reflects a culture of safety that includes reporting, analysis, rapid response and system-wide learning and improvement.

We must continue our collective efforts to transform the U.S. healthcare system to deliver higher quality care, lower costs and easier access for all. And, as the healthcare system moves rapidly into the digital age, we must work together to advance a framework that both protects patient safety and promotes the continued innovation that is necessary to address the significant challenges we face in healthcare today.  


Daschle, a senior policy advisory at DLA Piper, and Frist co-chair the Bipartisan Policy Center’s Health Project.