Health Information Management

EHR growth is a double-edged sword

APCs Insider, September 13, 2013

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As the use of electronic health records (EHR) grows, providers across the country are learning that with the enhanced convenience of digital records come new challenges and procedures.

Health information exchange (HIE) increased by 41% between 2008 and 2012, according to a recent report from the Office of the National Coordinator for Health Information Technology (ONC). In fact, six in 10 hospitals actively exchanged EHR with outside providers and hospitals in 2012, more than doubling the amount in 2008.

But increased reliance on EHR carries risks beyond the already complicated task of keeping the data secure. While using EHR can result in greater efficiency, it may introduce some new problems.

The Pennsylvania Patient Safety Advisory recently reviewed 324 EHR reports that included default values instead of more detailed information specific to that particular patient. While 314 reported errors did not result in harm to the patient, two involved temporary harm to patients that required treatment, while two others included temporary harm that required initial or prolonged hospitalization.

The group concluded that the errors resulted from incorrect “default values” being reported. Either the user did not change default values in a report or the software autopopulated a field with an inappropriate default value.

“Reports of wrong-time errors were the most prevalent, followed by wrong-dose errors, inappropriate use of auto-stops, and wrong-route errors,” according to the report. The group also assessed the cause of the error when possible and found failure to change a default value was reported most frequently. Other caused included user entries overwritten by the system, default values inserted into incomplete orders, and inability to change a default value. Analysts also noted that several reports indicated that a default value needed to be updated to match clinical practice.

While EHR could be a boon for efficiency and make record sharing easier, providers will have to keep in mind that the software still requires careful input and consideration to prevent avoidable errors.

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