- The Office of the National Coordinator for Health IT found a patient safety issue in 3.7% of all certified EHRs, or a total of 275 systems from nine vendors, according to researchers who analyzed surveillance data and published their findings this week in JAMA.
- The types of potential patient safety issues included laboratory test results not importing into the EHR properly, oral liquid medication restricted to milliliter dosing, improperly recorded codes for vaccines and decimal points being removed from medication dosage entries.
- From January 2016 to June, ONC investigated 697 EHRs from 195 vendors. More than 90% of cases were initiated in response to a reported problem while the remaining were selected randomly. Of those EHRs, just more than half had an issue that did not conform to certification standards, including 275 with a patient safety issue.
ONC certifies each version of an EHR product to ensure it meets the federal government's design, functionality and security requirements. The agency also inspects the products to ensure they still meet certification standards after they are installed and in use at healthcare organizations.
For the JAMA study, researchers from Georgetown University School of Medicine and MedStar Health National Center for Human Factors in Healthcare analyzed ONC's surveillance data to find out the frequency and types of patient safety issues uncovered. The researchers were not able to find out whether the potential safety issues led to actual patients being harmed.
The report is just one piece of recent research on the failings of EHRs. While the technology can save clinicians time and improve care coordination, the findings show that current products and practices leave much to be desired.
For example, a PLOS One report found that shortcomings in EHR design and functionality, workarounds and team communications put patients' safety at risk. To conduct the study, researchers observed care teams during morning rounds at a teaching hospital in New England. They also interviewed and surveyed inpatient clinicians.
Researchers observed extensive use of workarounds to make up for design flaws in EHRs, such as handwritten notes, emails and oral discussions.
A September study in JAMA Network Open found inconsistencies between the way emergency department residents documented patient encounters in an EHR and what trained observers witnessed; and another recent study found worse-functioning EHRs were correlated with higher reported levels of physician burnout.