Study links EHR usability issues to patient harm

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A number of reported safety events blame an EHR vendor or product for potentially contributing to patient harm, according to a study published March 27 in JAMA and reported by The American Journal of Managed Care.

A research team led by Raj Ratwani, PhD, combed through patient safety reports from 2013 through 2016 at 571 healthcare facilities across Pennsylvania and from a large mid-Atlantic muli-hospital academic health system.

Of 1.735 million reported safety events, 1,956 events (0.11 percent) cited an EHR vendor or product by name as a possible contributor to patient harm, while 557 events (0.03 percent) used language that explicitly suggested EHR usability contributed to possible patient harm.

"We specifically looked at EHR usability, which is really the extent to which a clinician can safely, efficiently, effectively and satisfactorily use an EHR or any technology for that matter," Dr. Ratwani said.

Of the 557 reports that suggested EHR usability was an issue, 84 percent of the reports required monitoring to prevent the patient harm event, 14 percent potentially caused temporary harm, 1 percent potentially caused permanent harm and fewer than 1 percent could have resulted in death.

Some of the patient harm events the researchers cited included an allergy alert that failed to go off, missed tests due to sloppy translations between physician orders and the EHR, and medication administration issues that cause a patient to be given an additional dose of medicine.

"We should not be tolerating anything that's going to cause harm, but it's also important to highlight that we took a very, very conservative approach in the way that we analyzed these data," Dr. Ratwani said.

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