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.
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