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Jeremy Faust is editor-in-chief of MedPage Today, an emergency medicine physician at Brigham and Women's Hospital in Boston, and a public health researcher. He is author of the Substack column Inside Medicine. Follow
The Trump administration suddenly cut all funding for the Patient Safety Network (PSNet) on Friday, Inside Medicine has learned. PSNet is an influential and respected project within HHS that has been dedicated to decreasing medical errors through research and knowledge dissemination. The endeavor has been credited with saving lives by helping change the culture by which clinicians learn from mistakes, thereby improving care.
The announcement came a day after HHS announced plans to terminate around 10,000 employees. The plans also included the "merging" of the Agency for Healthcare Research and Quality (AHRQ -- the agency that has administered PSNet) with another agency, to "enhance research that informs the Secretary's policies and improves the effectiveness of federal health programs." Cutting PSNet the very next day, it seems to me, goes directly against that goal, and calls into question the sincerity of the endeavor.
News of PSNet's fate was provided by Patrick Romano, MD, MPH, a University of California-Davis pediatrician who, until now, had served as the co-editor-in-chief of PSNet's Editorial Team. Here's Romano's statement to Inside Medicine:
"The University of California Davis is proud and honored to have been part of the Pantheon team supporting AHRQ's Patient Safety Network (PSNet) for the past 6 years. Due to shifting priorities for the Agency, the team will no longer be supporting PSNet. The funding has ended. The website remains live for now but is no longer being updated or maintained. We sincerely thank our 41,000 subscribers and millions of readers across the country, and we encourage users to access PSNet resources while they remain available."
PSNet was "the go-to resource online for trustworthy info and up-to-date studies on patient safety," Gordon Schiff, MD, a Harvard Medical School colleague of mine, said to me. Schiff made news of his own recently as one of the plaintiffs in an American Civil Liberties Union-supported censorship case against the Trump administration. In the complaint, Schiff argued that the administration had violated the First Amendment by tone-policing PSNet, requiring certain words to be deleted from previously published papers or else be taken offline. Schiff described the loss of PSNet as immeasurable. "It's the glue for the patient safety community," he said.
Making Patients Safer Through Transparency
The culture around medical errors changed dramatically this century, after a landmark document identified that the silence around mistakes had for too long meant that nothing was being learned. It argued that transparency could save lives. While thoughtful analyses suggest that the number of deaths from medical errors is likely lower than some of the headline-grabbing estimates indicate, the problem is very real.
"When something goes wrong in the hospital, should that be hidden and covered up, or should there be a culture of sharing and honesty about what went wrong?" Schiff asked. PSNet attracted researchers to make contributions because of its reach and rigor, and attracted patients because of its authority stemming from its status within HHS and the peer-review vetting that every resource on the site received prior to publication. In other words, PSNet was seen as an oasis of reliability in a messy internet.
One seasoned expert agreed. "As an emergency department chief at a safety net hospital, I've relied on...PSNet's extensive library of evidence-based resources -- from best-practice guidelines and case studies to education modules and patient safety tool-kits," Jeremiah Schuur, MD, told me via email. "Providers at every level, from nurses and pharmacists to hospital administrators, turn to this platform for strategies that reduce errors, lower costs, and improve outcomes."
He added that the Trump administration's decision to close the "cornerstone" of patient safety will hurt the general public by "compromising the quality and consistency of care across the entire healthcare landscape."
What We're Losing: Actionable Information
Why are cancer diagnoses delayed? Why are endometriosis diagnoses delayed? Are test results being communicated to patients in a timely and appropriate manner? Are doctors overusing antibiotics? What leads to delays in sepsis diagnosis and treatment?
If any of that matters to you, then you'd want PSNet to continue its mission as the epicenter for work like that, and more like it.
"We need a home for three decades of work on patient safety. We need a forum where new ideas can be advanced and controversies debated. We should be shining a light on medical errors, medication errors, diagnostic errors -- not just that they are happening but what we are doing about it so that we can move forward, and make advances," Schiff said.
Even a brief look at the current website gives a flavor of the work being championed by PSNet. As of Friday, the project's homepage highlighted recent work on adverse events related to telehealth -- an important innovation, but not a perfect one. Another study concerned communication errors in healthcare. Another assessed how large language models (artificial intelligence) could be vulnerable to data attacks.
"How can you destroy all that?" Schiff asked. "The cumulative investment of all the thinking and curation and wisdom -- it makes no sense." He also bemoaned the apparent lack of reasoning or accounting around why this is being done. "It just feels like slash-and-burn."
Improve It, Don't Incinerate It
PSNet has likely saved many lives, according to Paula Griswold, MS, the executive director of the Massachusetts Coalition for the Prevention of Medical Errors, an organization involved in public education on patient safety. Griswold said that PSNet's clinical goals, including infection prevention and improvements in medication safety, had already had a huge impact. But, she said, the project could even do more. "Let's improve it, not shut it down," she said.
Axing PSNet is counterproductive, she said, because decreasing medical errors not only improves outcomes but saves both private and public money. "To cut that off at the knees shows a complete lack of understanding of the challenges."
Overall, the experts I spoke with emphasized the practical and applicable knowledge that PSNet has disseminated to clinicians and the public. Unlike many government-funded programs whose impacts on the public are not always immediately apparent, PSNet focused on directly applicable information, "helping move ideas into action that isn't available in a lot of places," Griswold said. "They put information out for free that turned intellectual concepts into behavioral practice, and that made people safer."
She emphasized that PSNet has provided insights to improve the safety culture in healthcare by gleaning expertise from both frontline clinicians and patients. "It has helped patients and family members learn how to ask better questions."
A version of this post originally appeared in Inside Medicine.