Have electronic health records (EHR) enhanced the ability to measure quality and safety?
DB: Absolutely. Using electronic records to detect adverse events is one of the main areas that I’ve focused on the research front, but I’ve collaborated with other groups that have used IT successfully to detect falls and nosocomial infections. I believe that in the not-too-distant future it will be possible to build a computerized adverse event monitor that looks for all types of adverse events and delivers a reasonable, reliable assessment of safety levels–useful in a variety of ways. For example, we’ve used a computerized adverse drug event monitor to determine the impact of computerized prescribing with two different levels of decision support–more reliable and objective than chart review and peer review to assess medication safety. BR: What do you think of current efforts to use evidence-based clinical guidelines to improve health care quality? DB: There is a lot of redundant effort in guideline development and having a repository of actionable knowledge would be valuable, with
