One pill, two pills? Red pills, blue pills? Each year  more than 1.5 million people are injured by preventable medication errors, and, according to a new study in Pediatrics reported by the Associated Press, about one out of every 15 hospitalized children is harmed by a medication error--getting the wrong drug, the wrong dosage, or the wrong reaction.

We wrote about medication errors recently after actor Dennis Quaid related his baby twins'  ordeal to the  Association of Health Care Journalism conference last month. Quaid is using his celebrity to draw attention to practical ways of reducing medical errors. His newborns nearly died last November after receiving the wrong dosage of the blood thinner Heparin.

Reducing medical errors is an important goal in itself—the Institute of Medicine estimates that as many as 98,000 Americans die each year because of preventable mistakes. But that goal will be most effectively achieved as part of a comprehensive reform which would combine and amplify the incentives for developing health information systems, changing payment incentives and sharing best-practices among all clinicians.

Why, you ask? Improving quality is in many cases a question of realigning incentives. Doctor, patient and payer can all benefit from adoption of new technologies and higher standards.

In many cases, such as the use of beta-blockers after heart attacks, we know what works. We have evidence. But as AHRQ director Carolyn Clancy noted in a recent speech at Research! America, it takes about 17 years to bring much of what we learn and know to the bedside.  In other cases we don't have clear evidence-based guidelines for what works best, when, and for whom—as the Boston Globe's Dr. Victoria McEvoy made clear in her recent column, describing the difficulties prescribing medication for children when guidelines are sparse and clinical trials as hard to come by. Fortunately, our colleague Tom Emswiler reports there's hope Congress may pass comparative effectiveness legislation in the coming year.

As we noted last week, Medicare and some  private Insurers are taking steps to stop paying for certain preventable errors and "never events." We hope such steps can help move our country to a health system in which insurers focus on creating value rather than cherry picking risks, in which doctors are paid for providing the right outcomes, and where health IT measures are incorporated as both an economic and a medical necessity.