Study: Limiting clinicians to viewing a single record in the EHR may not reduce wrong-patient orders

Restricting clinicians to viewing only one patient's record in the EHR, versus having multiple patients' records open at once, does not appear to have an impact on the number of incorrect patient orders placed, according to a study published in the Journal of the American Medical Association.

The study, which was conducted between October 2015 and April 2017, comprised 3,356 clinician participants from a "large health system in New York," according to the report. The clinicians worked in emergency departments, inpatient and outpatient settings, and each study site had implemented a new EHR system during the time of the trial.

The researchers separated the clinicians into two EHR configuration groups: restricted and unrestricted. The restricted group, which had 1,669 participants, could only view one patient record at a time, while the unrestricted group, which had 1,687 participants, allowed up to four patient records to be viewed at once. The research team tracked near-miss wrong-patient orders through an electronic query system that searched for patient orders that were retracted and then reordered shortly after for a different patient but by the same clinician.

At the culmination of the study, with more than 12 million total patient orders, results showed that the proportion of wrong-patient order sessions was very close between the restricted and unrestricted groups. There were 90.7 wrong orders per every 100,000 made by the restricted group and 88 wrong orders per every 100,000 made by the unrestricted group.

While study authors concluded that restricting clinicians to a single patient record opened in the EHR did not reduce the proportion of wrong-patient order errors, they did note that clinicians in the unrestricted group made most of their patients' orders with just one record open. This therefore limited the study's ability to analyze the impact that the number of records open in an EHR can have on the accuracy of patient orders placed, the authors concluded.

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