Database Design to Ensure Anonymous Study of Medical Errors: A Report from the ASIPS collaborative
- Wilson D Pace, MD,
- Elizabeth W Staton, MSTC,
- Gregory S Higgins, BS,
- Deborah S Main, PhD,
- David R West, PhD,
- Daniel M Harris, PhD
- Affiliations of the authors: Department of Family Medicine, University of Colorado Health Sciences Center, Aurora, Colorado (WDP, EWS, GSH, DSM, DRW); The CNA Corporation, Alexandria, Virginia (DMH)
- Correspondence and reprints: Wilson D. Pace, MD, Department of Family Medicine: UCHSC at Fitzsimons, PO Box 6508 - Mail Stop F496, Aurora, CO 80045-0508; e-mail: <wilson.pace{at}uchsc.edu>.
- Received 29 January 2003
- Accepted 23 April 2003
Abstract
Medical error reporting systems are important information sources for designing strategies to improve the safety of health care. Applied Strategies for Improving Patient Safety (ASIPS) is a multi-institutional, practice-based research project that collects and analyzes data on primary care medical errors and develops interventions to reduce error. The voluntary ASIPS Patient Safety Reporting System captures anonymous and confidential reports of medical errors. Confidential reports, which are quickly de-identified, provide better detail than do anonymous reports; however, concerns exist about the confidentiality of those reports should the database be subject to legal discovery or other security breaches. Standard database elements, for example, serial ID numbers, date/time stamps, and backups, could enable an outsider to link an ASIPS report to a specific medical error. The authors present the design and implementation of a database and administrative system that reduce this risk, facilitate research, and maintain near anonymity of the events, practices, and clinicians.
Footnotes
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The authors acknowledge the contributions of all ASIPS participants, especially those who have entrusted them with their stories of medical errors. The authors thank Thomas J. Miyoshi of the Colorado AHEC System and George “Ed” Fryer, Jr., PhD, of the Robert Graham Policy Center for their analyses of the database's security features. Preliminary information concerning the database and data safety processes was presented at the North American Primary Care Research Meeting, New Orleans, Louisiana, October 2002. Funding for this study was provided by the Agency for Healthcare Research and Quality, grant # 1U18HS011878-01, Wilson D. Pace, MD, principal investigator.
