A recent RAND report discussing various innovations within the healthcare industry points out that while electronic health records have been shown to improve patient care, they are also a new source of medical errors.
Delving further into a subset of these EHR-related patient safety incidents, a study in the Journal of the American Medical Informatics Society has found a majority result not from user error but from the EHR itself.
Researchers analyzed a set of 100 unique patient safety incidents at Department of Veterans Affairs hospitals that were voluntarily reported to the VA between August 2009 and May 2014. Of these, 25 involved an unsafe use of technology, one involved a failure to use available technology and 74 primarily involved what the researchers called "unsafe technology."
The researchers noted many of the incidents were the result of a combination of workflow issues and human error combined with the shortcomings of the EHR. However, researchers identified four issues within the EHR that precipitated the patient safety incidents:
Unmet display needs: In 36 of the patient safety events, researchers found the information presented on the EHR screen did not adequately address the needs of the clinician end user.
Intended and unintended consequences of software modifications: Improperly configured software or upgrades and out-of-date software were involved in 24 of the patient safety incidents.
Data exchange failures: Poor patient-matching during data exchange or an inability to get necessary information from another hospital's system during an emergency was the primary factor in 17 of the patient safety cases.
Hidden dependencies within the EHR: Researchers found 17 incidents where the safe execution of one task within the EHR conflicted with another. For example, some of the medication information for an inpatient who was temporarily transferred to an outpatient setting was automatically deleted when the patient returned to the inpatient facility.
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