ICBioethics Blog 

Securing Patients’ Rights New Patient Safety Issue

Written by: Kathy Gennuso, Doctor of Medical Ethics

A recent article in Modern Healthcare discussed how end-of-life wishes and EHRs are out of sync. The author claimed that most Americans want their preferences known and honored, but emergency physicians, EMTs, and hospital or nursing home staff are not consulting their directives because they are not electronically accessible to them. Only few EHR developers have the ability to create, store, and exchange advance directives to make them easily accessible, yet it is technically doable today.

But it is not only inadequate technology that creates a disconnect between patients’ wishes and their care; there is a lack of attention to the importance of advance directives and other aspects of patient rights. Although protecting patient rights is a large aspect of patient safety, it has gone unaddressed. Last year IOM issued the report “Dying in America” highlighting the need to protect patients’ rights. Yet when policymakers released interoperability standards, advance directives, which support fundamental patient rights, received minimal attention.

The route to emphasizing and securing all patient rights could be made smoother by recalling the path patient safety implementation took. The patient safety movement identified that sustainable and powerful pressure from healthcare facility boards, as well as all levels of leadership, is required to make a significant shift in culture. And if pressure is not exerted from within, it will come from outside. Knowing this, boards of directors began to demonstrate their commitment to patient safety by closely overseeing their institutions’ efforts.

Many patient safety experts still believe that the threat of liability was an early barrier to hospitals’ development of effective and comprehensive patient safety programs.. However, eventual judicial recognition of an explicit “right to safety” for hospital patients, coupled with hospitals’ obligation to implement, motivated the development of systems to improve patient safety. Hospitals taking no action to improve safety would be viewed as negligent and subject to malpractice lawsuits when lack of adequate precautions resulted in injury. The same analogy could hold true for patient rights protections.

Patients’ rights applications exist today and can be integrated into most EHRs. Their use supports patient self-determination.

So remember patient safety: it wasn’t only technology that made the difference, but the increased prioritization and motivation to make it happen.

Mitch Gennuso