Human error at healthcare organizations is often associated with physicians unintentionally harming patients. While this scenario is common and serious, it’s not the only form of human error that takes place. Human error also happens in administrative roles. And sometimes, the mistakes can be just as damaging as those made in a clinical setting.
In order to improve patient care, healthcare organizations must root out human error in all its forms, whether it takes place on the operating table or in the back-office.
Medical error: 5 ways to combat mistakes made by clinicians
There’s a reason most people associate human error in healthcare organizations with medical error. In 2016, the CDC estimated that 251,454 deaths were caused by medical error, making it the third leading cause of death in the U.S., behind only cancer and heart disease.
James Lieber, author of Killer Care: How Medical Error Became America’s Third Largest Cause of Death and What Can Be Done About It, has identified five treatment reforms that can reduce medical errors across healthcare organizations:
Integrate pharmacists into patient areas. Erroneous pharmaceutical orders and doses cause thousands of deaths every year. Research shows that embedding a pharmacist in patient areas can cut medical errors leading to death or severe harm by 94%.
Loop multiple healthcare experts into key decision making. Misdiagnosis, delayed diagnosis, and other diagnostic errors often result from a physician’s blind spots. Lieber suggests looping other doctors and healthcare professionals into diagnostic decisions to combat bias and limitations.
Adopt structured handoffs. Two-thirds of all deaths related to medical error are caused by miscommunication during care transitions. Adopting structured handoffs that combine input between the patient, the new team, and the retiring team can eliminate confusion about the patient’s condition.
Enforce Centers for Disease Control guidelines for disinfection. 75,000 patients die every year from hospital infections. The CDC has explicit guidelines for cleaning medical tools, patient rooms, and other items in healthcare facilities. Lieber believes these guidelines should be mandatory.
Share patient data across healthcare organizations. Only 14% of clinicians share data with healthcare professionals beyond their organizations. Healthcare facilities must make sharing patient data a mutual priority to ensure quick and effective care.
Healthcare institutions can make concrete treatment adjustments to reduce medical error. But a less talked about form of human error also lurks within the medical bureaucracy. Human error in the back office, though less visible, can sometimes produce results that are no less damaging than medical error.
The Invisible threat
Administrative tasks, particularly processing paperwork, have always been an issue for healthcare organizations. Doctors in clinics perform nearly two hours of desk work for every one hour with patients. That’s why human error is often more likely to occur in the back office, as opposed to in a clinical setting.
Take, for instance, human errors that are made while determining Medicaid claims and eligibility. Medicaid eligibility errors, such as misapprising a patient’s income, can result in the rejection of qualified applicants and acceptable expenses. Since many Medicaid recipients are low-income patients that require intensive and complex care, any delay in coverage is potentially devastating.
Most healthcare organizations use human review to manually classify and extract data from Medicaid documentation, such as hospital bills, tax forms and bank statements. This is a costly and time-consuming process, with error rates for data entry as high as 4%. That comes out to 400 errors per 10,000 data points, a significant number that could jeopardize care for a significant number of Medicaid applicants.
Some healthcare organizations have employed optical character recognition (OCR) to replace human review. OCR reads and captures documents, digitizing the data quickly and efficiently. But OCR alone still suffers from suboptimal accuracy, because the software cannot process hard-to-read characters, such as a smudged letter on a Medicaid application. To confirm these difficult data points, healthcare organizations have to use human review, albeit on a much smaller scale.
To this end, organizations often combine OCR with Business Process Outsourcing (BPO). BPOs are off-site facilities that use human operators to perform data validation. But BPOs are still fundamentally human-oriented, relying on the whims of individual operators to produce accurate data, and are exposed to human error just as manual reviewers are.
For tasks as sensitive as Medicaid eligibility, healthcare organizations should harness programs that ensure the hyper-accurateness of validation tasks. Programs that combine OCR with aritifical intelliegence (AI)-powered human review and attended machine learning ensure that the extracted data is maximally accurate. Directed by the AI, human error is eliminated through multi-step checkpoints, and all validated data is learned by the system to increase accuracy and speed for future analyses. Human touch points are decoupled from the process as the system grows smarter, further decreasing the chance of human error.
For too long, back office errors have remained invisible in the discussion of healthcare outcomes. But new technologies are emerging that can finally help to eliminate this less discussed but entrenched problem.
Human error Is everywhere—it just happens to matter a lot more in healthcare
Medical error is undoubtedly one of the deadliest forms of human error today. As one of the nation’s leading causes of death, medical error is a core issue that healthcare organizations across the country must work to address. Research shows that there are concrete steps healthcare facilities can take right now to lessen the impact of medical error.
But not all human errors in healthcare organizations can be directly attributed to medical error. Nearly 45,000 Americans die every year due to a lack of healthcare coverage. And at least some of those coverage declines are the result of human error during back office processes, such manual review. However, as new technologies emerge, back offices in healthcare organizations can make the same strides toward eliminating human error as the clinicians.
Taken together, the improvements in patient outcomes could be significant.