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Study: Doctors Made More Note-Taking Errors With EHRs Than Paper

Posted on July 19, 2016 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.

A new study appearing in the Journal of the American Medical Informatics Association has concluded that a sample group of physicians made more data entry errors with a new EHR than in comparable paper records, according to a HealthcareITNews item.

Researchers studied progress notes created at a Michigan hospital, Beaumont Hospital of Royal Oak, Michigan, between August 2011 and July 2013. They looked at 500 notes created during that period, some of which were prepared before the EHR implementation in 2012 and some after. The charts contained five specific diagnoses which always include physical findings, including permanent atrial fibrillation, aortic stenosis, intubation, lower limb amputation and cerebrovascular accident with hemiparesis.

Upon analysis, they found that rates of inaccurate documentation were 24.4% with the EHR, versus 4.4% with paper records. Residents had fewer inaccuracies (5.3% vs. 17.3%) and omissions (16.8% vs. 33.9%) than attending physicians.

While this is no reason to throw the EHR baby out with the bathwater – after all, the physicians in question were learning a system for the first time – it’s still a troubling set of statistics. They are even more troubling given that EHR documentation errors can sometimes create patient safety problems of their own, especially in fast-moving care settings like the emergency department.

“There are new categories of patient safety errors” taking place in EDs that didn’t exist before EHR use became commonplace, according to Raj Ratwani, scientific director for MedStar Health’s National Center for Human Factors in Healthcare in Washington, D.C., who spoke with Kaiser Health News. For example, EHRs that only allow doctors to edit records for one patient at a time can make it harder to track ED patients, according to MedStar physician Zach Hettinger.

Without a doubt, the healthcare industry can’t afford to have its IT infrastructure creating new categories of safety errors or even making mistake-ridden documentation more common. Not only does this defeat the key goals for putting EHRs in place (improving care quality and efficiency), it could lead to a net increase in safety problems.

But as peanut-gallery observers like myself have been shouting for ages, the answer to the problem is fairly straightforward. EHR user interaction design has to be improved dramatically, and soon. This isn’t exactly a secret, but it seems that the issue is still treated largely as an academic discussion rather than one of immediate practical importance for providers.

I’m not sure why we haven’t made more progress on the user experience front in EHR design – or rather, which of the reasons can actually be addressed in our lifetime – but something’s gotta give.

VC Investment in Healthcare

Posted on April 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

There’s a real change happening right now in the venture capital healthcare investment world. In a recent article on NPR they highlight one piece of the change that’s happening with VC investment in healthcare:

The share of venture dollars flowing to seed and early-stage investments in biotechnology and medical devices has plummeted since 2007, when investors pumped $3.6 billion into 332 deals in which a price was disclosed, according to data compiled for Kaiser Health News by FactSet Research Systems. Overall venture investing declined by nearly one-third as the economic recession set in.

Many might look at this and say that this is a bad thing for healthcare. I think this this is a good thing for healthcare. One reason why is described in the same article:

“If you come in with [a device] that’s 10 percent better and twice as expensive, it’s hard to get anyone to care,” said Bryan Roberts, a Palo Alto, Calif.-based venture capitalist at Venrock, a Silicon Valley company that invests in firms working on health services, medical devices and drugs.

I think it’s healthy that we’re no longer investing twice as much money in something that delivers only partially better care. Sure, we still need companies innovating and looking at how that 10 percent better care can have an extra 0 on the end and be 100% better care.

Plus, I think we’re seeing a shift in healthcare investment into a large number of smaller companies who can innovate as opposed to larger sums of money into medical device and biotech companies. In some ways we’re seeing the costs associated with a startup company in healthcare starting to come down the way they did in the IT side of things.