John Bethune

As previously reported on the 24×7 site, the US Department of Health and Human Services has come up with a “roadmap” to create a new national health IT center. As proposed by the department’s Office of the National Coordinator for Health Information Technology (ONC), the center would have two key goals. First, it would promote a “culture of safety throughout healthcare.” In addition, it would also establish “a national learning system that enables health IT and its users to generate better and safer patient care outcomes.”

Now at this point, some readers are undoubtedly thinking, “Yeah, right—they’re from the government and they’re here to help.” But whatever you may think of government involvement in this area, the ONC’s report documenting the proposal is well worth reading. It recognizes and explains the fact that where patient safety is concerned, no number of rules and procedures is sufficient. What is required, rather, is a culture of safety. And although the ONC report doesn’t say it, I believe there is a central role for healthcare technology management professionals to play in promoting such a culture.

The ONC report builds on a 2012 study it commissioned from the Institute of Medicine, which “at its core,” argued that “health IT safety is a shared responsibility.” As the report explains, “the responsibility for ensuring the safety and safe use of health IT is shared by the range of stakeholders who design, develop, implement, use, support, and benefit from these technologies. Shared responsibility requires concrete actions by these stakeholders, and, therefore, collaboration among them.”

Happily, the report does actually name biomeds as one of the stakeholder professions. However, “biomedical engineers” appear just once in the 45-page document, at the end of a long list of “health IT professionals” including “chief information officers (CIOs), chief medical informatics officers (CMIOs), nursing informaticists, health IT privacy and security professionals, risk managers, [and] health information management professionals.”

It should go without saying that all those professions play important roles in ensuring health IT safety. But I would argue that with their unique responsibilities for the interface between technology and patients, biomeds are in a position to play an outsized role in promulgating a culture of safety. At the same time, though, HTM professionals can only play this role if they fully and enthusiastically embrace collaboration with their peers in IT.

In this blog last month, I noted just how challenging it will be to achieve the necessary level of cooperation. The topic was a presentation by Stephen Grimes at last June’s AAMI conference, focused on developing a common standard for building such collaboration. At one point, Grimes asked his standing-room-only audience whether IT and HTM/CE departments work together well enough “to offer seamless support of the new converged technologies.” The answer was overwhelmingly negative—88% of his listeners answered “no.”

Given this response, if biomeds are going to take what I believe is their rightful place as leaders in building a culture of IT safety, they will first have to find a solution to this significant impediment. What roadmap they choose does not matter. They just need to navigate their way to full cooperation with their colleagues in IT.