At ECRI, we recently released our 18th annual Top 10 Health Technology Hazards list for 2025 and I’m struck by how eerily familiar the top few issues are: artificial intelligence, home-use medical devices, and cybersecurity. We have been sounding the alarm about these issues on our Top 10 list for several years. AI has made the list four out of the last five years. We flagged cybersecurity as a tech hazard eight years in a row. Home-use medical devices have been one of our top hazards five out of the last six years.

If these are known problems, what barriers prevent healthcare leaders and clinicians from doing more to fix them? What is the cultural problem in our industry that’s leading to persistent patient harm?

I described part of the problem in the Four Greatest Weaknesses in the American Healthcare System, including our industry’s bad habit of troubleshooting hazards in silos, without the systems-approach and transparency that keeps other high-risk industries comparatively safer. Our 2025 health tech hazards underscore how these underlying weaknesses can amplify the necessary and inherent risks of adopting new technologies.

As an industry, we have a dangerous tendency to view new technologies as the cure-all solution to a myriad of woes plaguing healthcare. From a place of overly optimistic confidence, we tend to adopt new tools without mapping out the impact they make on the larger care ecosystem, with sometimes reckless, hazardous implementation. This is especially true in the use of AI and in the medical device industry, where we grapple with an ever-present challenge to balance the motivation to innovate quickly and launch new tools to improve patient outcomes and quality of life, with the demand and consumer-expectation that we do so safely.

It is not surprising that we see some of the same issues make our top ten list each year. As technology advances and healthcare moves into the home, new risks are bound to arise. Healthcare stakeholders can and must do more to adapt to this new era of medicine.

The good news: a transformative, integrated strategy—one that includes system design, human factors, and a commitment to equity—can build a better, safer future. A Total Systems Safety approach (TSS) moves organizations away from reactive, disconnected interventions toward a holistic, proactive, and sustainable safety system, powered by a “just culture” for our healthcare workforce. Human factors engineering (HFE) combines psychology and engineering to design safer healthcare systems. By addressing all facets of healthcare, TSS and HFE enable leaders to identify all of the system factors that contribute to safety issues and make meaningful changes.

Recognizing safety issues is an important first step, but the work cannot end there. By embracing a total systems approach, healthcare stakeholders and policymakers can move the needle on some of the most pressing and persistent patient safety threats.