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Patients Use an Internet Technology to Report When Things Go Wrong

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The reporting of medical errors by health care providers can hinge on many factors—their awareness of events, professional judgment, and a general willingness to come forward. To supplement this information, it is important that patients—who may experience harm from these events—also give their accounts. Using a Web-based survey developed to improve communication between doctors and patients, researchers at Dartmouth Medical School explored the feasibility of patients reporting adverse events. Their study, supported by The Commonwealth Fund and the Robert Wood Johnson Foundation, focused on one survey item from the online survey——that inquired about medical errors. Of 44,860 survey responses between April 2003 and April 2005, 610 respondents indicated an adverse event had occurred to them or a family member in the previous year. The survey responses were reviewed by two malpractice attorneys who agreed that 9 percent of the adverse events seemed serious enough to represent a possible compensable injury (i.e., the costs of the legal remedy could be greater than costs of litigation). Twenty-six percent of hospital-based events were possibly compensable compared with 7 percent of those in outpatient settings. They also discovered that of the variables considered, burden of illness had the greatest association with a report of a possible adverse event. The study’s results, say the authors, suggest simple, Web-based tools represent an inexpensive means for clinicians to learn about patients’ experiences, acknowledge problems, investigate causes, and initiate solutions.

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J. H. Wasson, T. A. MacKenzie, and M. Hall, "Patients Use an Internet Technology to Report When Things Go Wrong," Quality and Safety in Health Care, June 2007 16(3):213–15.