Do EHRs Sacrifice Accuracy?

By Katie Wike, contributing writer

According to one retrospective study, doctors say accuracy of paper records trumps that of electronic ones.

EHRs promise to make the documentation process more streamlined, but doctors say they still see inaccuracies since the switch from paper charts to electronic records.

A study recently published by the Journal of the American Medical Informatics Association finds while physician progress notes tend to be more accurate in paper records, there is more information omitted in paper notes than in the newly installed EHRs.

Fierce Healthcare EHR reports researchers looked at documents from Beaumont Hospital in Royal Oak, MI between August 2011 and July 2013. This involved the review of some 500 notes, both before EHR implementation in 2012 and after. They studied five specific diagnoses:

● permanent atrial fibrillation

● aortic stenosis

● Intubation

● lower limb amputation

● cerebrovascular accident with hemiparesis

Researchers found in the case of physical exam findings, EHRs had a 58.4 percent accuracy rating while paper records had a 54.4 percent rating. However, the rate of inaccurate documentation with EHRs was 24.4 percent, while paper records were only 4.4 percent. When it came to missing information, expected physical exam findings (such as the presence of a murmur) was more than 20 percent more likely to be omitted in the paper notes.

“During the initial phase of implementation of an EHR, inaccuracies were more common in progress notes in the EHR compared to the paper charts. Residents had a lower rate of inaccuracies and omissions compared to attending physicians,” concluded researchers. “Further research is needed to identify training methods and incentives that can reduce inaccuracies in EHRs during initial implementation.”