Wednesday, July 23, 2014

How Electronic Health Records Sabotage Care

Our new information overlords bring many benefits to patient care.  No, really, they do.  I’m sure you can come up with one or two aspects of patient  safety improved by modern health information technology.  However, it’s been difficult to demonstrate benefits associated with electronic health records in terms of patient-oriented outcomes because, as we are all well aware, many EHRs inadvertently detract from efficient processes of care.

However, while we intuitively recognize the failings of EHRs, there is still work to be done in cataloguing these errors.  To that end, this study is a review of 100 consecutive closed patient safety investigations in the Veterans Health Administration relating to information technology.  The authors reviewed each case narrative in detail, and divided the errors up into sociotechnical classification of EHR implementation and use.  Unsurprisingly, the most common failures of EHRs are related to failures to provide the correct information in the correct context.  Following that, again, unsurprisingly, were simple software malfunctions and misbehaviors.  Full accounting and examples are provided in Table 2:


Yes, EHRs – the solution to, and cause of, all our problems.

“An analysis of electronic health record-related patient safety concerns”
http://jamia.bmj.com/content/early/2014/05/20/amiajnl-2013-002578.full

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