News Feature | June 25, 2014

Complicated EHRs Can Jeopardize Patient Safety

Katie Wike

By Katie Wike, contributing writer

EHR Patient Safety

Working out the bugs of an EHR system takes longer than expected and, according to a study published in JAMIA, long-term EHR problems can pose a serious threat to patients.

A recent study published in the Journal of the American Medical Informatics Association has concluded, after analysis of EHR systems, safety issues remain long after installation. “A recent Institute of Medicine report called for attention to safety issues related to electronic health records (EHRs),” explained researchers. “We analyzed EHR-related safety concerns reported within a large, integrated healthcare system.”

According to iHealth Beat, the study used the Veterans Health Administration's Informatics Patient Safety Office in their analysis of EHR-related safety concerns. Using this data, researchers were able to extract 100 consecutive closed investigations occurring between August 2009 and May 2013. From these 100 incidents, they discovered that 74 involved unsafe technology and 25 involved unsafe use of technology.

Those events involving unsafe technology often cited system failures, computer glitches, false alarms or “hidden dependencies,” a term for what happens when a change in one part of a system inadvertently leads to key changes in another part, according to Modern Healthcare. The events involving unsafe use of technology most often found input error or misinterpretation as the culprit.

According to the study, the most common reasons for these problems were: data transmission between different parts of the EHR system; EHR information display issues; problems related to software upgrades.

Surprisingly, the research team found that these errors were not the result of new EHR systems or staff working out the bugs of their new records technology. “EHR-related safety concerns involving both unsafe technology and unsafe use of technology persist long after ‘go-live’ and despite the sophisticated EHR infrastructure represented in our data source.”

“Because EHR-related safety concerns have complex socio-technical origins, institutions with longstanding, as well as recent EHR implementations, should build a robust infrastructure to monitor and learn from them,” concluded the report.