Motivating Physicians Trumps Technology Issues at AMA Delegates Meeting

CHICAGO -- The American Medical Association (AMA) is downplaying the importance of information technology in a new push for patient safety.

A new AMA program, called Making Strides in Safety, incorporates the 100,000 Lives Campaign of the Institute for Healthcare Improvement (IHI), a Cambridge, Mass.-based organization that promotes patient safety. The IHI effort asks hospitals to take six measures to save 100,000 lives by June 14, 2006, and then 100,000 more lives in each subsequent year. (See Since its launch last December, the 100,000 Lives Campaign has signed up more than 2,200 facilities nationwide and now is shifting into its first implementation phase.

In explaining Making Strides in Safety and the 100,000 Lives Campaign to the annual AMA House of Delegates meeting here Monday, AMA officials talked more about motivating physicians to participate than how health-IT can prevent medical errors.

"Our materials right now about the 100,000 Lives Campaign are really awareness and leadership tools to get physicians involved," said Modena Wilson, M.D., senior vice president of the AMA's Professional Standards Group. "We're really trying to provide tools for physicians to get involved."

The AMA's Physician Consortium for Performance Improvement is developing Web-based performance-improvement tools for measuring outcomes, Wilson said, but otherwise technology is barely an issue.

"Technology plays a role, both positively and negatively," said newly reelected AMA House of Delegates Speaker Nancy Nielsen, M.D. For the negative, Nielsen cited a controversial March study in the Journal of the American Medical Association that was critical of poorly planned computerized physician order entry systems but that looked at a rather antiquated system. (See "Let's use technology where it is appropriate," Nielsen said, but added, "It is possible to sustain changes without technology."

The 100,000 Lives Campaign is an attempt to set up a "reusable infrastructure," according to Donald M. Berwick, M.D., president and chief executive of the IHI, but the recommendations took into account fact that the majority of U.S. hospitals currently do not have electronic medical records.

"None of the interventions we are pushing require information technology, though information technology certainly can help with measurements and assessment," Berwick said. "It's not essential, but probably helpful." A more pressing issue, he said, is convincing skeptical doctors and nurses to change flawed processes. "We have to be naïve a bit and reach out to them," he said.

During a question-and-answer session with Berwick and Nielsen, Randolph Gould, M.D., an AMA delegate from Virginia, said that "everybody is frightened" over the prospect of acknowledging mistakes. "I don't know if we get it," Gould said of the physician community.

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