Handhelds Can Help Catch Medical Errors

FRAMINGHAM (04/24/2000) - Pharmacists and others pushing to reduce the number of medical errors are putting more drive into the sometimes moribund trend in the medical industry toward handheld-based systems to link information on drugs, patients and specimens.

At least 44,000 Americans die each year as a result of medical errors, making such errors the eighth leading cause of death, according to estimates in a report issued last year by The Institute of Medicine in Washington, a federally funded division of the National Academy of Sciences. The total cost of injuries related to medical errors is more than $17 billion a year, the institute said.

"Error reduction is a top mission at this hospital and the prime reason we instituted our handheld projects - not that we had high errors in the first place," said Michael Mutter, pharmacy manager at The Valley Hospital in Ridgewood, New Jersey, a 412-bed facility.

The hospital is concerned about keeping costs low with any information system, but what drove the hospital's push to implement handhelds was the need to cut down on errors, Mutter said.

Hands-On

Valley Hospital has begun a beta test of a medication-delivery system that involves SPT 1700 handhelds from Symbol Technologies Inc. in Ridgefield, New Jersey The handhelds are equipped with bar-code scanners. In another project, Valley Hospital in the past year has used handhelds to guide technicians through record checks when blood samples are taken.

Becton, Dickinson and Co. in Franklin Lakes, New Jersey, is providing the software and systems support for the projects. Valley anticipates spending more than $200,000 and expects to recoup that investment within about two years through administrative efficiencies like eliminating the need to enter data from paper forms or redo a blood test done on the wrong patient, which could lead to expensive additional days of care, Mutter said. In the thousands of blood samples taken each month, four to six were typically taken from the wrong patient or involved a mislabeled sample. Using the Becton Dickinson system, those errors have been eliminated, Mutter said.

"Handheld verification systems promise lots of improvements, but the technology alone won't prevent errors," said Mike Cohen, president of the Institute for Safe Medical Practices in Huntington Valley, Pennsylvania. It will "take time to get these systems implemented and productive."

Cohen and other analysts said the information technology infrastructure at most hospitals has been deficient in preventing errors, especially drug overdoses.

American Medical Response (AMR) in Aurora, Colorado, this month is implementing a hand-held system for 250 paramedics.

Using a Palm Inc. handheld to quickly collect patient data on preset forms may reduce errors caused by illegible writing on paper forms, said Lon Adams, an AMR paramedic in San Mateo County, California.

Another advantage of the handhelds is that the information will flow into a database to help doctors and paramedics determine which emergency treatments are truly beneficial. "We're finding that many of the treatments we thought were of benefit were not and in some cases actually harmed patients or complicated their in-hospital treatment," Adams said.

AMR is spending $75,000 on the handheld system, part of a $500,000 project to Web-enable the San Mateo County ambulance service, which serves 17 towns, said Eric Gee, manager of AMR's handheld project.

The American National Red Cross in Washington is building a handheld system that blood donors will use to register and answer a 40-question survey. The goal is to reduce errors and get risk-factor data into screening systems faster, said Red Cross process engineer Christopher Patton.

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