We have often commented on studies that show low physician productivity and frustration with electronic medical records, and how difficult it is to quickly get the key facts needed in the clinical trench. These are common themes.
Now a new concern has emerged with this far-reaching technology: patient safety.
Most (94%) safety concerns related to either unmet data-display needs in the EHR (ie, displayed information available to the end user failed to reduce uncertainty or led to increased potential for patient harm), software upgrades or modifications, data transmission between components of the EHR, or ‘hidden dependencies’ within the EHR.
But human beings always have a role to play and are part of the complex equation leading to both good and bad care decisions.
Most often, non-technical dimensions such as workflow, policies, and personnel interacted in a complex fashion with technical dimensions such as software/hardware, content, and user interface to produce safety concerns.
The article uses a great example of this: a pharmacist makes a data entry error and inputs a higher dose of a diuretic than normal. A warning appears on his screen that is known to have a high false-positive rating, so the pharmacist overrides the warning and the incorrect dose is subsequently administered to the patient.
Even the most sophisticated EHR implementations should continuously monitor for safety issues, the authors advise.