Technology is playing a vital role in our lives. It is reaching into every field – even the critical ones, the ones on which our lives depend. Take healthcare for instance. By June 2014, funding for digital healthcare technology companies reached $2.3 billion, exceeding the entire total of 2013.
At the top of the list of these technologies are the EHRs (electronic health records), in which patient information (medical history, medications) is recorded.
Since the Obama administration began encouraging providers to adopt EHRs, usage of such systems has increased dramatically. At the end of 2013, 50 percent of doctor’s offices and 80 percent of eligible hospitals had EHRs.
There are some EHR issues that can hurt, or even kill. Jenny was killed by what was considered a bad UX (user experience) design, which I believe occurred in an EHR system in which three experienced nurses (more than 10 years of experience) missed a very critical piece of information, causing Jenny to miss her hydration for two shifts. This happened because the nurses were trying to figure out the software. Distracted, they overlooked that critical piece of information and care.
The hard truth is that UX issues in EHRs seem to be underevaluated. Ask yourself why you still see old systems in hospitals? Is it lack of new technology? The issue here is that when healthcare organizations decided to acquire EHR systems – priced in the millions – and those systems had poor usability, such organizations have been stuck! In other words, healthcare organizations will be burdened with poor usability for the life of those systems. And poor usability can mean compromising of patient safety.
Need more proof? Take a look at Scot Silverstein’s 84-year-old mother’s incident, caused by EHRs.
EHRs are prone to error
EHRs are being increasingly adopted. Doctors are now able to access all of the patient’s medical information online. This implies that the quality of healthcare should improve, right? I’m afraid that recent evidence shows that EHRs may prompt safety concerns when some network outage occurs. The fact that EHR problems are often complex and not easy to prevent led the Pennsylvania Patient Safety Authority to call attention to how EHRs can impact safety.
This study, The Role of the Electronic Health Record in Patient Safety Events, was performed to inform the field about the various types of EHR-related errors and, at the same time, serve as a basis for further study. Explored were 3,099 EHR technology-related reports. The majority involved errors in human data entry, such as entry of wrong data or the failure to enter data, and a few reports indicated technical failures on the part of the system itself,
Toward safer EHRs
Many issues that may arise from EHRs and affect patient safety are mentioned in this report. If we focus on data-entry issues, since those represent the majority of EHR-related errors, the following actions can be taken in order to avoid such errors and increase patient safety:
- For EHR certification, usability concerns have to be taken into account – how the system can be used without confusion.
- It should be stated clearly what the vendor’s EHR systems is able – and not able – to do.
- The healthcare organization should implement policies and strategies for appropriate EHR use.
- The healthcare organization should ensure that all users of the EHR system receive thorough training.
- An internal report system that identifies issues related to EHR usage must be implemented.
- Critical areas in the system that lead to risk factors must be well-identified, and access to such areas should be restricted.
An organization using an EHR system has to raise awareness of how critical such systems can be to the patient’s life, and have a team dedicated to training the staff on addressing any issues that may occur.
If used properly, EHRs can enhance patient welfare, since his or her information is easily accessible. However, if EHR safety concerns are not seriously taken into account, catastrophes can occur.