Recently, premature deaths associated with preventable harm to patients at hospitals was estimated at more than 400,000 per year.1 Serious harm appears to be 10- to 20-fold more common than lethal harm. This is roughly one-sixth of all deaths that occur in the U. S. each year and costs Medicare over four $4 billion a year.1,2 However, recent advances in technology offer hope.
Our health care system appears to be facing a perfect storm: an aging population causing greater demand, cost of health care which is twice the average of other advanced nations,3 shortage of health care providers, non-availability of suitable technology for patient care, and executing safe transitions between shifts and between inpatient and outpatient care. The situation is exacerbated by behavioral factors, such as noncompliance with medications and/or nonadherence to post-discharge care plans, which frequently lead to readmissions.4
These trends are necessitating adoption of new technology-enabled care delivery models that are proactive, continuous, connected, and geographically-independent. These delivery models facilitate connecting patients and their physiological data with their care providers both in inpatient and outpatient settings. These technologies include wearable sensors that collect and transmit information about a patient’s physiological condition in real-time and distribution of same information electronically at separate locations avoiding transcription errors.
Moreover, a 2012 eHealth patient survey found that overall 33% of patients and 40% of older patients desire access to technology that can alert physicians if they are having a health emergency.5 Some studies also indicate that these technologies can lower cost burden of some chronic diseases by as much as 30%.6
According to an AHRQ report, technology-enabled care models also have the potential to improve patient care.7 Acquisition of patient information continuously and in a timely manner would facilitate proactive engagement before symptoms deteriorate. The model encourages participation of all members of the care team, including patients and their families.
Using technology as part of an overall clinical care plan has been shown to reduce hospital readmissions.8 A two-year randomized clinical trial indicated that remote care programs reduced hospital readmissions to 7% – a dramatic 60% to 70% reduction from the control group (20%) and the national average (22%).9
The capability to seamlessly exchange health information electronically is the foundation to improve health care quality, access, and patient safety while providing greater security to medical information. Utilization of Health Information Exchange (HIE) can reduce up to 18% of the patient safety errors and as many as 70% of adverse drug events if the right information about the right patient is available at the right time.10 According to Kaelber and Bates, “better patient safety through enhanced, technology-enabled, HIE will directly improve patient safety because it will provide a more complete clinical picture of a patient.”10
They have identified six patient safety opportunities through HIE:11
- Medication Processing
- Laboratory Processing
- Radiology Processing
- Provider to Provider Communication
- Patient to Provider Communication
- Public Health Information Processing
Internet of Things (IoT) revolution promises to improve patient safety by enhancing connectivity and data distribution. Today, many medical devices operate independently and there is a need to combine the information from multiple devices to fully evaluate patient status. When a patient moves from operating room to ICU, his information does not travel with him. It has to be transcribed and manually configured on systems at the new location causing errors. If devices are controlled by a smart algorithm processor, they could communicate all information in real-time to the Electronic Medical Record (EMR) and replicated in a ICU system reducing errors inherent in manual entry.
IoT can be used in 3 different ways to enhance patient safety:
- Drug surveillance and preventing adverse events: Better integration of medical device data may save time, improve care coordination, and reduce up to half of all patient errors.12
- Better hand hygiene compliance cuts hospital acquired infections (HAI): At Greenville Health System in South Carolina and Mt. Sinai Hospital in Toronto, electronic hand hygiene monitoring raised the compliance rate among providers by 30%.13
- Monitoring patients in their home environment: Monitoring patients at home setting can alert providers of medical conditions before they escalate and protect patients from exposure to HAI.14