A new review of electronic health records (EHRs) by the Pennsylvania Patient Safety Authority found that mistakes made in EHRs can be farther reaching than errors using traditional paper records.
The study examined over 3,000 incidents over the course of 8 years that stemmed from EHR errors. In about 80% of the cases, the results were errors with medication, and many of the rest involved incorrect or unnecessary lab tests. In the medication errors, about half of the patients were prescribed the wrong medication, and another quarter were under medicated.
So why are mistakes traveling farther? Electronic systems are becoming increasingly networked to things like the hospital pharmacy or other health information exchanges. This means that an error that may have previously been caught before it was replicated may now cascade to other systems before being caught. The scale and amplification of mistakes has increased.
The article, published here, also points out that in the short run, more mistakes are being made. One cause of this could be the lack of training that users of the systems have received. Federal programs that incentivize the implementation of electronic systems, and deadlines that came with the 2009 stimulus funds may have caused a quick rollout of systems to staff members who did not yet know how to use them. Additionally, some facilities may be using EHRs in addition to paper records, producing incomplete information entered into the system.
In some systems, information that is typed into the wrong box is not recognized. In others, system glitches can cause issues, like random medication orders appearing in some patients records.
Most experts believe, however, that these are temporary setbacks. As time progresses, EHR systems will become smarter, and staffs will become accustomed to using them. Long term, most still agree that EHRs serve as an investment that will yield future gains.