While eHealth is often promoted as a tool to reduce health care risk, particularly with regard to medical error, little is known or understood about the risks that eHealth poses itself for patient and health care provider safety. By safety risk we mean the risk of physical or mental harm to patients and health care providers, including death.
Its not surprising that there is relatively little empirical information on the subject… eHealth itself is in its infancy and quite frankly, few if any people are tracking eHealth safety incidents. The odd incident is occasionally reported in the press such as a lab system failure in Calgary. One would expect some number of errors caused as a result of systems problems, but at the moment we’re not hearing about them.
That being said, it behooves us to address the question of eHealth safety before it becomes a significant issue. It seems that there are at least 3 areas where eHealth safety problems can originate:
Security issues – are the most likely sources of eHealth safety problems. Security concerns itself with the confidentiality, integrity and availability of information. Confidentiality concerns are not likely to give rise to safety issues (except in very rare circumstances, such as releasing the identities of doctors who perform abortions making them vulnerable to personal physical attack). Integrity and availability issues will certainly impact patient and health provider safety, particularly as we become more dependent on telemedicine services and electronic health records. Consider what could happen to a patient if a denial of service attack brought down an ehealth portal that provided access to critical health information systems, or if a virus corrupted or destroyed health data.
Quality of Product Issues – where software and hardware products fail to provide essential information when required, or deliver corrupted data. Software glitches are an example such as when a lab system fails to deliver accurate test results.
Human factors issues – where the human/ information system interface fails such as confusing user interfaces or overly complex procedures that promote error or fail to catch common user errors (e.g. input procedures that make it easy to enter the wrong data or displays that make it easy to misinterpret data).
There may well be others factors that give rise to safety issues. We need to identify such factors, understand them and then act to ensure that the systems we are putting in place to help people are not harming them.