Top 10 List of Health Tech Hazards Released

November 11, 2015

Poorly cleaned flexible endoscopes that can spread antibiotic-resistant pathogens are the top health technology hazard that hospitals and clinicians should tackle in 2016, according to a new report from the ECRI Institute.

The annual list of technology pitfalls issued by the nonprofit research organization also includes missed alarms for medical devices and inadequate monitoring of postoperative patients for opioid-induced respiratory depression, which can lead to brain injury or death.

Dirty endoscopes, particularly duodenoscopes used in endoscopic retrograde cholangiopancreatography, have set off a rash of sometimes deadly infections in recent years. In turn, the US Food and Drug Administration has issued guidance on cleaning, disinfecting, and sterilizing the instruments that goes beyond manufacturers' instructions. The agency states that reprocessed endoscopes have transmitted pathogens despite healthcare facilities strictly following the manual, and that the risk for infection cannot be completely eliminated.

In its annual hazard report, ECRI said that failing to thoroughly clean biological debris and other foreign material from these instruments can jeopardize the effectiveness of disinfection and sterilization that follows. The complex design of endoscopes and their low narrow channels can make cleaning a challenge, the group noted.

ECRI's top-10 list of technology hazards is not a ranking based simply on the volume of problem reports received by the group, or their severity. "Rather, the list reflects our judgment about what risks should receive priority now," ECRI stated.

The leading hazard identified by ECRI last year was health information technology (IT), such as electronic health records (EHRs). That broad category did not make the new list, but "exclusion of a topic…included on a previous year's list should not be interpreted to mean the topic no longer deserves attention," ECRI said.

One type of safety concern related to health IT made the list for 2016, however. Number six consists of errors that arise when IT systems do not support the workflows of clinicians and vice versa. For example, a clinician may not be able to find needed information in a poorly configured EHR. On the flip side, workflows may not accommodate the capabilities of health IT.

More information about the ECRI ranking is available on the group's website.

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