Patient safety remains, as it should, a priority for developers of and providers who use electronic health records (EHRs) and other health IT. For example, ECRI’s Partnership for Health IT Safety has worked with the HIMSS EHR Association on projects on opioids and behavioral health integration. More broadly, providers and developers continue active engagement in the Partnership and other patient safety initiatives.
When Washington Adventist Hospital of Maryland hired ECRI Institute to provide equipment planning services for their new 170-bed hospital, they were in a financial bind. Their Certificate of Need (CON) budget for patient care equipment was only $33 million. But, after we completed detailed user group meetings, it was clear that the actual cost for medical equipment would be closer to $65 million.
Our client was not alone in getting caught in the CON budget squeeze. Currently, 35 U.S. states maintain some form of CON program—including all states east of the Mississippi, except Pennsylvania and New Hampshire. CON programs give the state government the power to determine whether there is a need for a new hospital or nursing home before it is approved for construction.
Anti-microbial resistance (AMR) presents serious global concerns, now and in the future. The World Health Organization (WHO) lists AMR as a top ten threat to public health. Last year, there were 700,000 deaths worldwide from AMR. That number is expected rise to 10 million a year in 2050—more lethal than cancer—if we fail to change what we are doing today.
Google the term “superbug” and you’ll see close to 4,000,000 hits. The rise of superbugs—microbes resistant to powerful drugs—led the Centers for Disease Control (CDC) to create the AMR Challenge, a year-long effort to accelerate the fight against antimicrobial resistance across the globe. CDC mobilized commitments from more than 270 countries and organizations around the world, including my organization, ECRI Institute. Action-based commitments are key. Without action, many nations risk slipping back into the pre-antibiotic era, compromising the success of major surgery, cancer chemotherapy, and other health care—and serious economic impacts, too.
A 2019 JAMA viewpoint article, Is It Time for Safeguards in the Adoption of Robotic Surgery?, explores the risks associated with the increasing, uncontrolled, and indiscriminate use of robotic-assisted surgery. We could not agree more.
For more than two decades, ECRI Institute has been emphasizing these risks based on our evidence assessments and patient safety work. We do not dispute the many potential benefits of minimally invasive robotic surgery procedures. However, we are solidly grounded in the “show me the evidence” camp. Our concerns fall squarely in three areas: patient safety and surgeon experience, evidence, and cost.