Case study: EHR errors ‘significantly lower’ two years post implementation

EHR error rates dropped significantly two years after providers had transitioned from older, locally developed EHRs to commercial EHRs that featured clinical decision support (CDS) and implemented several system refinements, according to research published online on April 11 in the Journal of the American Informatics Association. The results underscore the positive outcomes of federal efforts to support meaningful use of EHRs, according to the research.

Erika Abramson, MD, assistant professor of pediatrics at Weill Medical College of Cornell University in New York, and colleagues conducted a cross-sectional case study of 16 physicians at an academic-affiliated ambulatory clinic from April to June 2010. Researchers utilized standardized prescription and chart review to identify errors in 1,905 prescriptions.

In all, the overall prescribing error rate was 3.8 per 100 prescriptions. “Providers positively appreciated most system refinements, particularly reduced alert firing,” according to the study.

“Our study suggests that over time and with system refinements, use of a commercial EHR with advanced CDS can lead to low prescribing error rates, although more serious errors may require targeted interventions to eliminate them. Reducing alert firing frequency appears particularly important,” Abramson et al concluded. Ongoing error monitoring can promote safe EHR practices in the future, the authors added.