Each year, ECRI (the ECRI Institute) publishes an annual report on the Top 10 Patient Safety Concerns for the year. The 2025 list was published today. My read of it is that most of these risks have to do with what I’ve been referring to as the Human OS, the Human Operating System, in my talks and teachings.

 

 

 

 

 

 

 

 

 

In this post, I’ll focus on 2 of the 10 most top-of-mind in my current workflow with clients and speaking: #1 and #3.

Here’s the list of 10, calling out:

  1. Risks of dismissing patient, family, and caregiver concerns
  2. Insufficient governance of AI in healthcare
  3. The wide availability and viral spread of medical misinformation
  4. Medical error and delay in care resulting from cybersecurity breaches
  5. Unique healthcare challenges for caring for Veterans
  6. The growing threat of substandard and falsified drugs
  7. Diagnostic error: the big three – cancers, major vascular events, and infections
  8. Persistence of healthcare-associated infections in LTC facilities
  9. Inadequate communication and coordination during discharge, and,
  10. Deteriorating community pharmacy working conditions contributing to medication errors and compromising patient and staff safety.

 

 

 

 

 

 

 

 

 

 

Here is ECRI’s list of patient safety concerns a decade ago in 2015. Compare these with the top 10 safety concerns for 2025. Many more of these have to do with “technology” and devices (e.g., alarm hazards, med errors related to pounds vs. kilograms, mix-up of IV lines), noting several issues still plaguing the U.S. health care system today: namely,

  • Managing patient violence
  • Inadequate patient handoffs– but in this case, related to patient transport

#5 and #9 in the list 10 years later identify care coordination challenges, which continue to mar health care quality in the U.S. as more patients get discharged to hospital-for-home and more acute-care workflows that fall on burdened caregivers (that is, family members and friends).

And today, data integrity and health IT risks have morphed into cybersecurity threats and the spread of mis-information outside of EHRs.

 

 

 

 

 

 

 

Let’s dive into #1 of the top first: the risks of dismissing patient, family, and caregiver concerns. Nearly all patients have felt their symptoms had been ignored or dismissed by a doctor at some point, ECRI asserts. When this happens to a patient or their caregiver, it feels like “medical gaslighting,” ECRI explains.

The definition of medical gaslighting offered by the American Journal of Medicine is that it’s derived from the term “‘gaslighting,’ when an individual is manipulated into questioning their own perception.” Physicians might not realize they are engaging in this behavior, lacking understanding of certain conditions or having unconscious or cognitive biases. This behavior can lead to missed and delayed diagnoses, and exacerbate health disparities — especially among female patients, as well as Black patients (and Black women more than Black men).

 

 

 

 

 

 

 

 

 

 

Next consider the viral spread of medical misinformation, accelerated during the COVID-19 pandemic. “False information is 70% more likely than the truth to be shared on Twitter (now known as X) and will reach people six times faster,” ECRI quotes a report from the journal Science. 

With 3 in 5 U.S. adults seeking medical information online, there is a ripe market for so-called “health influencers” and other bad actors to put out mis-information for profit and notoriety, with the rate of unsafe treatments putting people at-risk of adverse events and medical mishaps. Consider the growth of TikTok in medical information, for example.

“When healthcare professionals collaborate with patients, it leads to more informed decision-making and improved health outcomes,” ECRI recommends….with the prescription for misinformation being health literacy.

Speaking of health literacy, ECRI walks the talk and gives us many resources concluding each of the ten patient safety risk chapters that we can review for ourselves, learn from, and act on.

Health Populi’s Hot Points:  ECRI’s introduction to this year’s report starts with a prescription for the macro-solution to the ten risks:

“This new era of patient safety requires heightened vigilance, new and adaptive strategies, and a commitment to fostering a culture of safety with health-literate practices that ensure the well-being of patients in an increasingly digital, complex, and interconnected world.” 

 

 

 

 

 

 

 

 

 

In their methodology for curating this list, ECRI takes what they call a total systems safety (TSS) approach incorporating four pillars which together drive patient safety:

  • Patient & family engagement
  • Learning system
  • Workforce safety & wellness, and,
  • Culture, leadership, & governance.

Keep in mind that ECRI is a science-based, fiercely independent organization in its operational DNA. So I quote from the report this impactful recommendation for taking action and meaningfully measuring improvement:

“Healthcare leaders must be intentional about implementing solutions in their own complex, unique organizations. Superficial attempts will not be enough to make meaningful changes in improving patient safety.   Organizations should segment data to better understand inequities that may create disparities in both patient and workforce outcomes.”

I am taking this last sentiment quite seriously today as I craft a new speech-talk for an upcoming meeting where I have been asked to discuss health equity in the context of high-cost health care. In conducting research for my talk today, I note a news update regarding Google’s approach to “health equity” online.

From STAT (sorry, behind a paywall):  “A STAT review showed that the company’s ‘health equity’ page has been retitled ‘health optimization’ and the company’s global head of health equity, Heather Cole-Lewis, has a new title: global head of health optimization.”

How that impacts my ability to search the term “health equity” in Google technically, I have no idea. But what I know is that such an announcement, if it does impact the liquidity and accessibility of evidence-based information that relates to drives of health, equity, and access, will compromise patient safety, health literacy, and the overall Human Operating System.