Most of us have heard the frightening statistics reported in To Err is Human, the Institute of Medicine report published a decade ago on medical errors and patient safety. That and subsequent reports – not to mention the attention received by Presidents Bush and Obama – helped put electronic health record (EHR) development and implementation into warp speed.
One component within an EHR is an alert system. Most of these alert systems focus on medication orders – is the dose wrong for the patient’s weight, is the patient allergic to this med, is the med contraindicated in pregnancy, etc. But what about food allergies? Most EHRs do not have alert systems for this. Proposed Meaningful Use requirements included no mention of non-medication allergies. Why the omission? The impact on the patient is the same. Allergy lists and alerts within EHRs should include non-medication allergies and should address drug-nutrient interactions. ADA has given testimony to this effect.
Why should this be a priority? Just look at some of the statistics. Up to 7 million Americans, including 2 million children, are affected by food allergies. Thirty-five to 50 percent of cases of anaphylaxis are due to an allergic reaction to food, and 150-200 Americans die per year as a result of food allergies. In addition to food allergies, as many as 6 million Americans are allergic to latex, including 5% to 15% of health care workers. Because the proteins in latex are similar to those in certain foods, persons with a latex allergy are usually also allergic to bananas, chestnuts, kiwi, passion fruit, and avocado.
Several software systems exist to automate functions of food & nutrition departments. Most include interfaces so that when a food allergy is entered in a patient’s EHR, this information is sent instantaneously to the software system. The software system then removes items to which a patient is allergic and can insert appropriate substitute items in their place.
We can’t adequately ensure patient safety without the presence of food allergy and drug-nutrient interaction alerts, as well as a mechanism to prevent items to which a patient is allergic from being served to them. We need to continue this dialogue with EHR vendors and EHR implementation teams.