Electronic health records (EHR) is a patient centric information resource for physicians that represent a major domain of health information technology (HIT). The EHR system facilitates improved communication between healthcare providers; promotes patient safety thereby enhancing quality of care. Even though EHRs enhance patient care, many do not recognize that adverse patient safety issues stemming from this system have a long-lasting effect.
A new study of health IT implementation conducted at seven Department of Veterans Affairs (VA) hospitals shows that EHRs when implemented without adequate planning and management can create problems related to patient safety. The study was published in the Journal of the American Medical Informatics Association (JAMIA). As part of the study, the researchers chose 100 closed patient safety investigations related to EHR system (that happened between August 2009 and May 2013) and covered about 344 incidents.
Researchers analyzed the core safety issues related to the use of this technology along with human and operational factors such as clinical workflow demands, user behaviors and organizational guidelines. More than 70% of investigations identified a mix of two reasons for each problem. The key findings of the study are mentioned below –
- About 74 events were related to unsafe use of EMR technology and include confusing displays, upgrade glitches and system failure, improperly configured software, false alarms, and hidden dependencies (situations in which a considerable change in one part of the system significantly changes the integral aspects in another part of the system).
- Another 25 events were related to issues such as an input error or a misinterpretation of a display.
Patient safety issues are particularly significant at this time when the healthcare industry is working continuously to fulfill the meaningful use of ICD-10 guidelines. Often, healthcare providers in an attempt to fulfill the federal requirements do not pay much attention to patient safety issues. Moreover, healthcare providers who do not demonstrate meaningful use of EMR by 2014 will receive reduced Medicare and Medicaid reimbursement by 1% in 2015. Additional cuts will be applied in 2016 and 2017 thereby reducing the overall reimbursement.
Researchers reveal that the more complex an electronic health record system, the more difficult it will be to identify the problem. Even when hospitals are planning to integrate this information system, it is important for them to understand the potential complications related to connectivity. With this system, making an entry into patient health records is directly connected to the pharmacy system which in turn is connected with the medical billing system. Therefore, hospitals planning to incorporate new software or add updates need to be strategic about key changes and proactively include ways to monitor them.