Excerpted from Dr. Woodward's keynote address to the First Annual Symposium of the Betsy Lehman Center for Patient Safety on Dec. 2, 2004

Five years after the landmark Institute of Medicine report, To Err Is Human, every physician I know is more aware of the magnitude of this issue and is working to improve patient safety. For that and many other reasons, I'm optimistic about our ability to enhance patient safety.

Examples of success in patient-safety improvement abound. At Renaissance Health, a practice in Arlington, patients have electronic access to their own medical records and receive a follow-up phone call after every office visit to ensure they understood all the information and have filled any prescriptions.

A second example is occurring in my emergency department at Emerson Hospital, where we are beginning to use a computer system capable of rapidly accessing patient prescription histories. The system helps us diagnose drug reactions, avoid potential drug-drug interactions, and provide safer, more expeditious, and more effective care.

And now Massachusetts has two large-scale technology projects that are laying foundations for fostering improved patient safety. First, there's the DOQ-IT (Doctors' Office Quality Information Technology) program, a federally funded pilot that is helping 150 primary-care practices in our state select and implement electronic health record (EHR) systems.

I'm even more excited about the Massachusetts eHealth Collaborative, a consortium of 34 Massachusetts health care organizations whose goal is a statewide, fully interconnected EHR platform that incorporates decision-support tools [see related article] and that will enhance patient safety across the Commonwealth.

As we're laying the necessary user-friendly IT foundation, we also need to foster behavior that leads to continuous patient-safety improvement. Perhaps the biggest impediment to achieving that is our dysfunctional medical liability system. Many of the fundamental elements we need for a culture of safety -- near-miss reporting, full disclosure, and open communication -- are undermined by the current liability system. Thankfully, in addition to our efforts here at the MMS, many initiatives are underway to overhaul the liability system and tie it to patient safety. Physicians must -- and will -- be leaders in these efforts.

No matter how well-trained or highly skilled we are, humans make mistakes. So we need advanced technology, complete with up-to-date, evidence-based clinical guidelines, to help us make the best possible decisions, based on the most complete information every time. Let's leverage state-of-the-art technology to enhance communication and improve the efficiency, quality, and safety of the care we deliver.

- Alan C. Woodward, M.D.