EHRs Could Be Causing Patient Harm More Often Than Expected

Posted on December 26, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Why did the healthcare industry invest so heavily in EHRs in recent years?  Obviously, one major reason is the payoffs that became available under HITECH, but that’s not all.

Another important objective for spending heavily on EHRs and other HIT options was to protect patients from needless harm, including everything from clinical decision support to finding grand clinical patterns among patients with similar conditions.

Now, nobody’s saying that none of these benefits have been realized. But according to one researcher, we haven’t paid enough attention to the ways in which these technologies can actually cause harm as well. In fact, some researchers say that HIT-related mistakes are not as minimal or easily managed as some think.

So how do we get a grip on how often HIT tools and EHRs are a factor in patient care errors? One way is to examine the role HIT has played in malpractice claims, which, while not offering a comprehensive look at how such mistakes occur, certainly gives us a look at where some of the biggest have taken place.

For example, look at this data from the Journal of Patient Safety, which dug into more than 300,000 cases from an insurance database to see what role HIT played in such cases. Researchers found that less than 1% of the total malpractice claims involved HIT, more than 80% of that 1% involved problems of medium to intense severity.

The researchers found three major reasons for EHR-related suits:

  • 31% involved medication errors, such as the case when a baby died from a drug overdose that took place because a handwritten order was entered in the computer inaccurately
  • 28% involved diagnostic errors, as when critical ultrasound results ended up being routed to the wrong tab in the EHR — which in turn led to a year-long delay before a cancer patient was diagnosed
  • 31% of cases were related to complications of treatment related to HIT errors. For example, in one case a doctor was unable to access emergency department notes, and the lack of that knowledge prevented the doctor from saving the patient

Unfortunately, if you’re a physician group member working within a hospital — particularly as an on-call clinician with little say about how HIT system should work — your group may be vulnerable to lawsuits due to technologies it doesn’t control.

Still, it doesn’t hurt to learn about common errors that can arise due to EHR and HIT malfunctions. When it comes to delivering patient care, the fewer surprises the better.