This commentary reflects how high-performing healthcare organizations use health information technology to advance patient safety.
Despite increasing awareness of the risks to patients within the US healthcare system and the human and economic toll that medical errors exact, improvements in patient safety have been slow.1,2 While individual accountability for patient outcomes is essential for the delivery of high-quality medical care, the complexity of healthcare requires a highly reliable system built within a culture that recognizes errors and process defects as opportunities to learn and continuously improve. The Institute of Medicine report To Err is Human emphasized the important role of health information technology in preventing harm to patients.3 Through the automation of errorprone tasks and decision support systems designed to minimize reliance on human memory, health information technology has rapidly become an important tool to address problems faced by healthcare organizations and their patient safety programs.
In this essay, we describe the fundamental role of health information technology as a multifaceted and indispensable tool to achieve high reliability in healthcare. We illustrate how health information technology can contribute to the creation of high performance by discussing the operating characteristics of high-performing organizations and how they achieve superior outcomes. Finally, we caution readers that this technology has the potential to disappoint or even harm if poorly designed, implemented, or embedded within an institution that lacks a culture of safety. We write these opinions in our roles as healthcare leaders in an academic medical center that has a well-developed computer physician order entry system and a partially developed electronic medical record.