6 Best Practices on Preventing Technical Errors When Using EHRs

Jim Walker, MD, chief medical information officer at Geisinger Medical Center in Danville, Pa., discusses six ways hospitals can prevent technical errors when using electronic health records.

1. Identify problems beforehand. Geisinger implemented hazard control, which aims to identify problems with a system before fully deploying it. Dr. Walker says 40,000 hours are dedicated to testing a product before it become available to the rest of the medical center.

"For example, if a user looks at a medication list in one particular setting versus another setting, they can get different information," Dr. Walker says. "Once we've identified that, we could have the vendor come to fix that hazard before the product goes live."

2. Train and test physicians and staff. Geisinger provides extensive classroom and online training to physicians and staff on how to use EHRs. Physician groups also review the effectiveness of training, as physicians and staff are required to pass a test before using the system.

"The training is focused on what they need to know when using EHRs in real-life scenarios," Dr. Walker says. "We work very hard to make sure training provides just enough information. After training and testing, everybody that uses the system can produce a record of their own and demonstrate they can use it safely."

3. Focus on usability. Dr. Walker says a lot of thinking goes into customizing EHRs to make sure the systems are user-friendly. He meets with a number of Geisinger physicians and staff approximately five times a week to discuss ways to discuss ways to improve EHRs usability.

"We try very hard to think in terms of what questions they'll have as they use these EHRs and how we can make it easier for them to understand it," Dr. Walker says. "It's hard work but incredibly important."

4. Reduce the amount of typing. Considering the average typing error rate is 3 percent, Dr. Walker suggests customizing EHR systems in a way that minimizes typing.

"By getting rid of the opportunity for someone to re-enter something, you eliminate the risk that whatever they enter may have an error," he says.

5. Log errors and resolve them. At Geisinger, users report any errors or issues to the production support team. As soon as a user reports a problem, a support team member not only responds immediately by offering help to the user but also discusses with the team how to prevent that error from happening again.

6. Employ support staff. Shadow trainers, which are support staff that help physicians and nurses while they are on the floor, and a help desk help offer additional support in understanding and using EHRs.

"Shadow trainers are at clinics or on the floor with physicians and nurses to help them and answer questions right there in the moment because no matter how much you train, new issues come up all the time," Dr. Walker says. "Anyone that has a question or concern with the system can also call one number or [send] an email, and the help desk will get that issue delivered to the right person. We make sure support staff get back to physicians quickly."

Learn more about Geisinger Medical Center.

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