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ECRI lists top tech hazards for healthcare


February 1, 2018

Improperly reprocessed gastrointestinal scopes, subpar disinfection procedures, cybersecurity threats, and flaws in medicine administration systems will continue to threaten safety in U.S. healthcare facilities in 2018, and priority action should be taken to reduce the risk to patients. That’s the opinion of safety advocate ECRI Institute, which has released its annual Top 10 list of health technology hazards.

“The safe use of health technology — from beds and stretchers to large, complex imaging systems — requires identifying possible sources of danger or difficulty with those technologies and taking steps to minimize the likelihood that adverse events will occur,” according to the executive brief of the document.

The list is produced each year by ECRI Institute’s Health Devices Group, and identifies the potential sources of danger that the group believes warrant the greatest attention for the coming year. The list does not enumerate the most frequently reported problems or the ones associated with the most severe consequences, but rather the risks that should receive immediate priority.

ECRI Institute (formerly the Emergency Care Research Institute) is a Pennsylvania-based independent, nonprofit organization that researches approaches to improving patient care.

The usual suspects

ECRI’s 2018 list will be familiar to many people in the healthcare safety field, as several of the identified problem areas have been discussed for some time. The technology hazards it names are as follows:

  1. Ransomware and other cybersecurity threats to healthcare delivery
  2. Endoscope reprocessing failures, exposing patients to infection risk
  3. Possible infection of mattresses and covers by body fluids and microbiological contaminants
  4. Missed alarms resulting from inappropriately configured secondary notification devices and systems
  5. Improper cleaning, which can cause device malfunctions, equipment failures, and potential patient injury
  6. Unholstered electrosurgical active electrodes, which can lead to patient burns
  7. Inadequate use of digital imaging tools, which may lead to unnecessary radiation exposure
  8. Workarounds that can negate the safety advantages of bar-coded medication administration systems
  9. Flaws in medical device networking, leading to delayed or inappropriate care
  10. Slow adoption of safer enteral feeding connectors, leaving patients at risk

“The safe use of health technology — from beds and stretchers to large, complex imaging systems — requires identifying possible sources of danger or difficulty with those technologies and taking steps to minimize the likelihood that adverse events will occur,” the ECRI report says. “This list will help healthcare facilities do that.”

Specifically, for healthcare clinics, the topic of improperly reprocessed GI scopes will continue to be a problem, as clinics increasingly perform outpatient procedures while dealing with staff that are not properly trained in scope cleaning and reprocessing. Colonoscopy and other diagnostic scopes are among the most frequently used medical devices in America, employed in approximately 14 million colorectal cancer screenings happening each year and used 55 million times per year overall.

The scopes can be cleaned, disinfected, and ready for reuse in as little as two hours, but their reprocessing instructions need to be followed exactly as supplied by the manufacturer, and they usually involve several steps: pre-cleaning with special fluid, forcing air through the scopes to check for leaks, and intense brushing to remove residue before disinfection and drying procedures. In some hospitals, personnel dedicated to scope disinfection are specially certified, but safety experts say such personnel are not required (a good thing, as many smaller clinics don’t have them).

Cybersecurity will be another hot topic to watch as attacks against healthcare groups threaten patient records and electronic systems. Ransomware encrypts the files on a computer or network; criminals often demand that payment be made in bitcoin or another untraceable digital currency before agreeing to unlock the files.

An attack on a Los Angeles hospital in February 2016 seized control of the hospital’s computer system and forced administration to pay a $17,000 ransom in bitcoin to regain control. The hacker, who was never caught, had originally demanded $3.4 million from the hospital to restore the computer system. The disruption caused some patients to be transferred to other hospitals, postponed some procedures such as CT scans, and prevented some patients’ medical records from being accessed, according to reports.

To obtain a copy of the 2018 ECRI report, check out www.ecri.org/Pages/2018-Hazards.aspx to register and download the report.

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