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Tip of the week: Consider technology shortcomings and other ethical issues when implementing your EHR

HIM Connection, July 30, 2007

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Although computers and software are fantastic tools, they aren't foolproof. The people who operate technology aren't foolproof, either. EHR structure is not always ideally suited to clinical care. Some clinical communication doesn't fit into the typical automated structures, so certain kinds of information might be lost.

Consider the situation in which an EHR requires a user to enter certain information in order to progress to the next screen. Some users are tempted to type inaccuracies because they're just trying to get past that point, says Bonnie Kaplan, PhD, FACMI, lecturer at the Yale Center for Medical Informatics in New Haven, CT. Other times, they don't bother to complete all of the fields because the requested data is not clinically relevant in the current context. Then, when another clinician tries to use the record later, the user can't separate the good information from the bad.

Also, in some instances there is a mismatch between people's work sequence and the work sequence the EHR structure requires. For example, in an emergency situation, a physician might verbally order medication on the spur of the moment, and then someone must properly update the EHR later.

Ensure that your EHR implementation plan addresses technology shortcomings as well as several other ethics challenges, including insufficient laws, checks and balances, patient protection, job duties, record integrity, decision-making, flexibility, and privacy and security.

Editor's note: This tip was adapted from the August issue of Electronic Health Records Briefing. For more information, click here.

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