How EHRs affect malpractice suits

April 21, 2020

Should doctors worry about EHRs leading to malpractice suits?

With EHRs now widespread, many doctors worry that their use will lead to more malpractice suits, due either to human error or flaws in the systems themselves.To learn more about this, The Doctors Company, a national malpractice insurance provider, recently analyzed the role of EHRs in claims it closed between 2010 and 2018.

Introduction

The company found that EHRs were a factor in 216, or 1.1%, of all claims closed during the period, and typically were a contributing factor rather than the primary cause of a claim.

However, the annual percentage of claims involving EHRs grew during the period, from just under 0.4% in 2010 to 1.2% in 2018

EHR factors that contributed to patient harm, by category*

User issues: 60%

Technology and design issues: 48%

*Some cases may have multiple contributing factors so total percentage >100%

Top clinical services with EHR factors

Internal medicine: 8%

Family medicine: 8%

Cardiology: 6%

Radiology: 6%

Obstetrics: 5%

Orthopedics: 5%

Nursing: 5%

Hospital medicine: 4%

Gynecology: 4%

Emergency medicine: 3%

Anesthesiology, plastic surgery, urology surgery, general surgery: 3% each

EHR-related patient injuries

Death: 25%

Adverse reaction to medication: 23%

Surgery required due to EHR-related error: 15%

Emotional trauma: 14%

Undiagnosed malignancy: 13%

Organ damage: 11%

Infection: 9%

Ongoing pain: 7%

Mobility dysfunction: 6%

Top categories of allegations in EHR-related cases

Diagnosis related: 31%

Improper medication management: 11%

Improper management of surgical patient: 8%

Improper management of treatment plan: 7%

Improper performance of surgery: 7%

Medication ordering-wrong medication: 5%

Medication ordering-wrong dose: 5%

Improper performance of treatment or procedure: 5%

*Categories with fewer than 5% of allegations not included

Top EHR technology and design issues contributing to patient injury

Electronic systems/technology failure: 12%

Lack of/failure of EHR alert/alarm/: 7%

Record fragmentation: 6%

Failure/lack of electronic data routing: 5%

Failure/lack of routing of data: 5%

Insufficient scope/area for documentation in EHR: 4%

Lack of integration/incompatible systems: 2%

Other: 14%

Top EHR user-related issues contributing to patient injuries

Incorrect information entered in EHR: 13%

Pre-populating/using copy & paste: 13%

Hybrid health records/EHR conversion issues: 13%

Training and/or education: 7%

Alert issues/fatigue: 2%

Workarounds: 2%

User error, other: 12%