Incorporating Disease Management Protocols into an Electronic Medical Record: A Case Study in Reducing Medical Errors—Can Healthcare Achieve Six Sigma?

Six Sigma is a bold business process strategy reaching far beyond traditional quality-based programs. This strategy is described in the book Six Sigma by Mikel Harry and Richard Schroeder (Doubleday and Co., 1999). In the world of manufacturing and production, error rate is measured according to a standard deviation: the higher the number (1 through 6 Sigma), the lower the number of errors or defects per million. This article challenges everyone involved in delivering healthcare to incorporate this concept into the business of healthcare. United States healthcare expenditures are the world's highest, and yet we still have not reached a level of Wellness, health, and disease prevention and management to justify the dollars per capita spent on healthcare. Do these dollars reflect our "error rate"? Could the qualitative and quantitative cost of illness be positively impacted in the direction of Six Sigma through the use of technology in disease management programs? Could we turn the paradigm from healthcare dollars spent (or error rate) to reduction in healthcare costs, and in so doing improve health, Wellness, and the disease management process, which in turn produces an improved quality of life or Six Sigma? We are technologically advanced in so many areas of healthcare. The challenge is to use this technology to create and support disease management programs, exploiting it to prevent and reduce medical errors. Harnessing the power of an Electronic Medical Record to effectively incorporate disease management protocols is an important first step toward achieving these goals and approaching Six Sigma.