Surveillance shows potential in detecting HIT system failures

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An Australian study finds potential value in applying a syndromic surveillance system to health IT systems to detect early system failures.

Such surveillance typically is used in public health to monitor the spread of infectious diseases. The system was used in research at the University of New South Wales in Sydney to monitor four factors in a tertiary hospital laboratory: total number of records being created, the number of records with missing results, average serum potassium results, and total duplicated tests on a patient.

The researchers, led by Dr. Mei-Sing Ong, wanted to detect HIT system failures causing: data loss at the record level, data loss at the field level, erroneous data, and unintended duplication of data, according to a paper published at the Journal of the American Medical Informatics Association. Statistical models were used to detect system failures using simulated outages lasting 24 hours, with error rates from 1 percent to 35 percent.

At the record level, the model's sensitivity grew from 0.26 at 1 percent to perfect sensitivity at 35 percent. Meanwhile, perfect sensitivity for detecting missing results, erroneous serum potassium results and unintended repetition of tests was achieved at just a 5 percent error rate, leading the authors to tout the system's potential.

Several studies have called into question the data quality of information used in EHRs. A study from the database of the National Hospital Ambulatory Medical Care Survey of the disposition of patients who underwent intubation found a "clinically important" level of discrepancy--including 11 patients listed as both dead and alive.

A previous study also published at JAMIA, found that research methods for using EHR data are inadequate and can result in "significant bias." And the ECRI Institute recently named three health data errors among its among top 10 health IT hazards.

And that's when EHR systems are used under normal conditions. Hurricane Sandy, which prompted hospital evacuations when backup generators failed, provided yet another wakeup call for the need for effective disaster planning, including for communications and power outages.  

To learn more:

- Read the abstract.

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