Despite their promise to improve care and save money, electronic health records (EHRs) occasionally can actually cause or exacerbate medical errors.
This could be a big deal from a legal perspective for healthcare providers because bad IT might lead to more liability litigation. “The plaintiff’s bar is getting much more attentive to this issue,” said Scot Silverstein, M.D., a professor of health informatics at Drexel University in Philadelphia and a longtime critic of what he sees as poorly designed health IT. (Silverstein has long chronicled problems with “bad health IT.”)
“People can continue on with what they have, but, boy, they’d better be careful,” Silverstein said in a recent interview. He added that EHR users and vendors are “coming into focus as potential subjects of litigation.”
Electronic Health Records could easily lead practitioners to make the same types of errors as with paper records, except EHR errors might magnify adverse events or affect more patients that those related to paper charts, a 2012 review by the Pennsylvania Patient Safety Authority found. That’s because information in EHRs can be more easily disseminated to many people, whether or not the records are correct.
About 81 percent of the adverse events reported to the state agency involved medication ordering and administration, the report said.
In 2013, the American College of Emergency Physicians identified four types of errors that information systems could make in emergency departments: communication failures; poor display of data that might make it “incredibly easy to miss abnormal results”; mistakes matching the right order to the right patient; and “alert fatigue” that causes clinicians to tune out truly critical warnings.
Copying and pasting of previous documentation could perpetuate errors, according to a 2010 story in EyeNet, the magazine of the American Academy of Ophthalmology. This practice could also give the wrong impression that previous observations were current.
With this growing body of evidence, the attitude that EHRs can only be beneficial is “cavalier,” according to Silverstein. That is something that should worry compliance officers and legal departments.