Patient Safety: Crossing the Quality Chasm, the Technology Way.

Improving patient safety is all about taking stock of our actions, processes and outcomes; auditing them; isolating problem areas and improving them. This was exemplified by Florence Nightingale, when during the Crimean war she cut mortality at the British camp from 42% to 2% after statistical studies she made showed soldiers dying not from their wounds but from infections from sewer and poor hygiene. Dr. Codman instituted the first morbidity and mortality conference at Harvard when findings from a study of all 337 patients discharged from his hospital between 1911 and 1916 showed clinical errors in 123 cases (over 1 in 3 patients) in follow up. Clinical audits and error reporting are the main crux of patient safety, but without adequate Documents management clinical audit might be impossible and error reporting only used for punitive purposes only. With Document management, audit is easy and error reporting is spontaneous and could be anonymously used for constructive reviews. Universally, Electronic Health Records (EHR) and Health Information Technology (HIT) are the way to go in achieving this, but the bane of adoption of them are so much with us viz-aviz power supply, lack of IT infrastructure, IT illiteracy, lack of will power and fear of disruption of flow of traditional ways of doing things. Intelliform is the basis of this simple paper technology which employs barcodes, preformatted text boxes, check boxes, radio boxes and paper mapping on all our traditional clerking/continuation sheets, treatment sheets, prescription notes and more. A small study carried out in Lagos, showed Intelliform in itself raising the level of care. A rise from 58% to 97% in improvement in accuracy of diagnosis measuring pertinent aspects of history taking covered using Intelliform and normal papers; fewer prescription filling-out errors; information indexing was 8 to 1 faster than normal paper based records; when used with InkSearchTM for data mining, indexing and cross referencing patients information can achieve over 2000% faster rate than normal paper based records. Other endearing features of Intelliform are hardware independence and non-specificity; the cheap cost, same as printing normal hospital stationeries; flexibility, can be produced on the fly; adaptability to any form or type of clinical practice; ease of use, very intuitive and user friendly. At the current practice, it is difficult aggregating medical information for meaningful use or study and becomes more as the number of patients swells and paper piles up. By employing simple paper technology we will be re-engineering our practices without changing the agelong way of doing things but we will almost be world standard compliance and our practices future-ready.