EHRs may put chemotherapy patients' safety at risk, study finds

Problems in EHRs, such as outdated information and incomplete notes, can cause treatment delays as well as safety and communication issues between chemotherapy patients and providers, according to a study published in Journal of Oncology Practice.

For the study, Ann Arbor-based University of Michigan researchers measured safety culture as well as satisfaction rates with clinic technology and clinician communication among 297 oncology providers. The researchers surveyed the providers, which included nurses, physicians and advanced practice providers across 29 practices in the Michigan Oncology Quality Consortium, a statewide collaborative.

When asked whether they were satisfied with communication technology, 69 percent of respondents said they were satisfied with all paper or paper and electronic records, while 42 percent of participants said they were satisfied with all electronic records. Researchers also found that clinicians in settings with the most sophisticated EHRs reported lower safety scores. Higher satisfaction with technology and better clinician communication was associated with higher safety scores, according to the report.

Common EHR problems include physicians, nurses and pharmacists receiving different patient information, EHR hardwiring that limits certain functions to select providers and physicians not completing notes in real time, which leaves nurses and other care team members without updated information on patients scheduled for chemotherapy.

"Chemo[therapy] is a high-volume, high-risk endeavor and most patients receive these treatments in centers like the ones we studied," Christopher Friese, UM nursing professor and principal investigator on the study, said. "Unlike some other treatments, there's no reversal, there's no antidote, we have to get it right the first time."

Despite challenges posed by EHRs, Mr. Friese said some sites in the study with sophisticated EHRs reported high safety scores. Researchers are now analyzing the sites from the study with the most and least EHR problems to extract best patient safety methods.

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