Barriers to bringing in PPID systems

CAP Today

July 2011
Feature Story

By and large, the hospitals that have implemented positive patient identification systems report improvements in patient safety, patient satisfaction, staff efficiency, and staff morale. Still, not everyone is satisfied with the progress being made in the PPID marketplace. Raymond Aller, MD, clinical professor of pathology and director of informatics at the University of Southern California, Los Angeles, says too few hospitals are embracing this much-needed technology.

“Since the technology became available in the late ‘80s, I’ve been concerned that we as laboratorians and hospitals have not moved aggressively enough,” he says. “Even under the very best of manual systems, in blood banking scenarios where they double- or triple-check, there’s on the order of a one in 1,000 error rate—labeling patient No. 1’s sample with patient No. 2’s name-ID number. An error rate in a manual scenario where there isn’t as much cross-checking could be two percent or more. Why do we allow this to persist? One big reason is we don’t know it’s there. Most of the time, the errors aren’t detected. If the patient does poorly, we assume it’s just because the patient’s sick, as opposed to we’re treating the wrong test result.”

Even granting that some laboratories are unaware of the magnitude and impact of the problem, why aren’t more hospitals implementing positive patient identification? Dr. Aller points to a couple of factors. First, he says, “Certain LIS vendors decline to connect with third-party vendors” of PPID. “They have decided they will only work with their own software to do this. That’s a disservice to the patient, because the third-party vendors have specialized in this area for several years and have a more robust model than some LIS vendors do. In a few cases, LIS-centric PPID modules may cost more, with less functionality, than third-party software.”

Second, in his view, “The hospital priority-setters often put funding for implementing positive patient ID at the bottom of the list. A number of vendors say that laboratories know they need to do this, but their hospitals don’t understand the importance of reliable patient identification.”

In the longer term, Dr. Aller says, given that positive patient identification is a fundamental safety feature, “shouldn’t it be a standard feature of all clinical systems, rather than an extra-cost option? Just as any car you purchase will come with seat belts, why shouldn’t every LIS and clinical system you install come standard with positive patient identification tools?”

—Anne Ford