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Electronic Health Records Yield Unforeseen Healthcare Safety Failures

The Centers for Medicare & Medicaid Services (CMS) defines the Electronic Health Record (EHR) system as the electronic version of patient medical history.  Healthcare providers actively maintain and update this record and may also “include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.”

CMS explains that with this new system of record keeping, which has been part of federal health policy since 2004, clinician workflow can be streamlined because the access to information has been automated.  This system also can support other “care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting,” the government health agency reports.

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According to the CMS, the EHR system can also improve patient care by cutting back on medical oversight in the following ways:

  • Reducing medical error incidents through improved accuracy and clarity of medical records
  • Increasing health information availability
  • Decreasing test duplication
  • Reducing treatment delays
  • Keeping patients well informed of their healthcare

Healthcare Reporting Discrepancies with EHR

Despite the promise of this new system of consolidating, updating, and freeing up the exchange of patient medical information, a recent study has highlighted some of the drawbacks seen with EHR.  The Agency for Healthcare Research and Quality points out that a study from the University of Pennsylvania found that “nurses working in an EHR environment are less likely to report poor patient safety compared to their peers working in non-EHR environments.”

According to this report, those nurses working in hospitals with fully implemented EHR systems “were significantly less likely to report unfavorable outcomes compared to nurses working in hospitals without fully implemented EHRs.”  Furthermore, fewer nurses in these facilities reported the following other patient health concerns:

  • Medication errors
  • Poor quality of care
  • Low confidence in patient fitness for release
  • When patient safety is a low priority for hospital management

Furthermore, nurses in EHR facilities showed a 14 percent decrease in their likelihood of reporting “things that fell between the cracks” during patient transfer to other units.  The unsurpassed level of health information transparency and timeliness available through this system has inexplicably led many healthcare professionals to subvert one its greatest strengths.

EHR Integration Failure

Another study from the Annals of Family Medicine illustrated the general limitations of EHR by looking at the treatment of diabetes with the use of this system.  After analyzing 16 EHR-using facilities and 26 locations that did not use this technology, researchers found no association of the technology with “better adherence to care guidelines or a more rapid improvement in adherence.”

After almost 10 years of federal efforts to push this record-keeping technology, this study found that practices are in desperate need of help with the implementation of this record system, “especially with regard to redesigning work processes to make the best use of these new technologies by all members of the primary care delivery team.”  The study concludes by explaining that if this technology is simply an electronic version of paper records, it is not being used to its fullest extent and may only create more quality care issues than it solves.

The CMS calls EHR the “next step in the continued progress of healthcare that can strengthen the relationship between patients and clinicians.”  However, recent studies have illustrated the unforeseen limitations and drawbacks of a system that is only as good as the medical professionals using it.  Until these improvements are made to this system and healthcare professionals fully embrace its potential, we have no reason to expect to see the desired decrease in avoidable healthcare mistakes and negligence.

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