One key benefit of implementing an EMR is improved patient safety, right? Better access to complete patient records, e-prescribing, easy-to-read physicians’ notes, drug interaction warnings and so on?
Not necessarily, says healthcare research organization the ECRI Institute. The group argues that HIT complications — which obviously dog EMR implementation and use — are one of the top health technology hazards for 2011.
According to the group’s research, dangerous HIT-related problems such as data loss, incompatibilities between multivendor software applications and systems, incorrectly entered or corrupted data, and errors in data analysis are quite capable of causing patient harm.
ECRI’s advice on reducing such risks includes the following, which should send a chill down the spine of any HIT manager: “Remember that help desk calls regarding computer equipment and systems may now literally be a matter of life and death,” the group says in its “Top 10 Health Technology Hazards for 2011” report.
As we all know, these problems are likely to get worse, not better, as EMR systems roll out, bringing with them a massively complex set of management and systems integration issues. Unfortunately, we don’t yet know just how bad things are likely to get.
Late last year, a patient safety organization called PDRSecure launched a Web site allowing visitors to report EMR safety-related events. (Those entering the reports have to supply their names, which is likely to slow things down more than a little.) So far, at least, PDRSecure hasn’t released data on incoming reports.
While your editor isn’t an academic, what little research I’ve seen on EMR safety seems to be inconclusive. Some general interest articles and bloggers argue that HIT errors are the big threat, and others suggest that mistakes made by still-training clinicians are far more dangerous, but I haven’t seen any hard evidence there either.
The bottom line, though, is that while we’re going through a comparatively giddy period of spending on EMRs, and awaiting the Meaningful Use dollars to come, it might be nice to keep the patient safety issue on the front burner. From where I sit, there’s been too little candid discussion of EMR risks.
So, where do you come down on this? How important is it to discuss EMR safety hazards? Have you seen incidents that concerned you? And here’s a scary thought: should the FDA regulate EMRs and demand routine critical incident reporting?
As with all technology, especially its increased use, there is a risk. Properly used though (and this is the crux) EMRs should present no greater hazard than paper charts, which were capable of being lost, misplaced, badly written, etc. Thank you for this post.
I’m now reading the transcript of the Feb 25th, 2010 HIT Policy Committee HIT Safety Hearing.
http://healthit.hhs.gov/portal/server.pt?open=512&objID=1473&&PageID=17117&mode=2&in_hi_userid=11673&cached=true
Gotta love this:
“On the usability issues, I‘m reminded of the human factors professor, Stephanie Guerlain, when she examined a whole bunch of EHRs. She said, you know, if HIT vendors designed a car, you‘d have to click on the speedometer icon to see how fast you were going. That‘s professor Guerlain, professor of human factor[s].”
I agree with it. EMRs should produce at greater risk than paper maps, which were able to become lost, misplaced, poorly written.
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