Effects of EHR-related patient safety issues linger
Patient safety issues stemming from EHR systems have a lasting effect.
That's the finding of a study published in the Journal of the American Medical Informatics Association. Researchers used the Veterans Health Administration's (VA) Informatics Patient Safety Office to analyze EHR-related safety concerns.
VA implemented its EHR system in 1999 and has since maintained a voluntary reporting system to collect and examine safety issues related to EHRs. The researchers culled 100 closed patient safety investigations related to the EHR system that occurred between August 2009 and May 2013. The investigations covered 344 incidents. The researchers reviewed the information for safety issues related to EHR technology, as well as human and operational factors, such clinical workflow demands, organizational guidelines and user behaviors.According to they study, 74 events were related to unsafe EHR technology including computer glitches; false alarms; hidden dependencies where a change in one part of the system inadvertently changes integral aspects in another part of the system; and system failures.
Another 25 events were related to the unsafe use of technology, such as misinterpreted screens or human input errors.Seventy percent of the investigations identified at least two reasons for each problem, the most common being the following:
- Data transmission between different parts of the EHR system;
- EHR information display issues, which was the most commonly identified problem; and
- Problems related to software upgrades.
The patient safety issues affected both new and longstanding EHR systems. Organizations "with longstanding, as well as recent EHR implementations, should build a robust infrastructure to monitor and learn from" EHRs because "EHR-related safety concerns have complex socio-technical origins," the authors wrote.
This issue is particularly concerning, said study co-author Hardeep Singh, a researcher at the Michael E. DeBakey VA Medical Center's Center for Innovators in Quality, Effectiveness and Safety, with the healthcare industry working to meet the requirements of Meaningful Use and the transition to the ICD-10 coding system.
Read the complete study.