It’s ironic: Experts in health IT concur that a major reason for healthcare systems shifted from paper to digital records was to reduce medical errors, but at the same time research has shown that EHRs actually introduce new kinds of errors.
“There’s a yin and a yang to everything,” says Jonathan Weiner, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “Health IT and EHRs have a very positive impact on quality.” Still, he says, as is true with any tool, mishaps and errors are possible and harm can result.
Most EHR errors occur in ambulatory settings
A research group led by Mark Graber, MD, who is with RTI international, an independent nonprofit that works on projects in both social and laboratory sciences, investigated the part played by health IT in malpractice claims.
Graber and his colleagues studied the role health IT-related mistakes played in more than 300,000 malpractice claims within an insurance database and published their findings in The Journal of Patient Safety. The group found that while health IT-related errors played a role in less than 1 percent of all the claims (248 cases), ambulatory care accounted for the majority of those cases (146 of the 248 total). Furthermore, 80 percent of the 248 health IT-related malpractice allegations concerned harms of medium-to-intense severity.
“EHRs are not really optional anymore. Data entry is a huge, time consuming thing to do, and to do it correctly takes a lot of time,” says Martin Derrow, MD, an internist in Maitland, Florida. He notes that when a physician is speeding up for efficiency’s sake and to fit in more patients, bad data entry habits can easily set in.
3 common traps to avoid
Experts agree that many, though by no means all, of the threats posed by EHRs are ones that individual users can address, although the responsibility for safe use of health IT is shared by diverse actors, including EHR vendors and healthcare system administrators.
Below are three suggestions that individual physicians can use to promote safe use of EHRs.
Be vigilant during times of transition: Graber’s team observed that many EHR-related mistakes occurred during periods when organizations were changing vendors or record systems, embarking on system upgrades, or extending the functionality of their systems.