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Mar 2016

Two Steps Forward, One Step Back with Electronic Health Records Technology

Growing up in the 1970s, I remember staring at the prescriptions my pediatrician had written down for my mom to take to the pharmacy. I wondered, how can anybody read the doctor’s chicken scratch?

Now, surely modern technology with electronic health records (“EHRs”) must make the medical community’s communication easier with a chance of error being far less likely. But as football analyst Lee Corso likes to say, “Not so fast, my friend.”

A computer mouse slips during a click, causing the ER doctor to check the wrong number, ordering a medication dosage that is far too large. In another hospital bed, the electronic health record for a patient’s name is not clearly displayed, causing the nurse to enter the patient’s symptoms in the wrong person’s file.

As old and new ER doctors and nurses transition to electronic medical record systems, mistakes seem to be happening more frequently. According to a Modern Healthcare article, one of the promises of the 2009 federal stimulus program, which provided financial incentives to hospitals that adopted EHRs, was a reduction in errors as physician and hospital patient records were linked. But in ERs, where things often happen rapidly, “the push for interoperability sometimes sets up a technology mismatch that creates challenges that aren’t necessarily as evident in other parts of the hospital,” the article stated.

Medical providers may rush between patients, juggling multiple cases. To service this hectic environment, many hospitals at first created EHRs that were independent of hospital-wide systems, Modern Healthcare reported. But those homegrown ER systems often aren’t compatible with the newer, comprehensive ones hospitals are buying, so they’re being phased out.

The newer EHR models often require adjustments to meet ER needs. According to Modern Healthcare, members of the American College of Emergency Physicians wrote a report in 2013 that found mistakes in the ER — such as ordering the wrong medications or missing key patient information because of confusing computer screens—were common after the switch to a new digital system. The 2013 report suggested many of the mistakes might be the result of poor design rather than user error. However, there’s no research measuring how often these errors cause actual harm to the patient.

So yes, electronic records have resolved many safety concerns in healthcare. Modern technology has rendered obsolete issues like ability to read a physician’s handwriting. Accessing a patient’s medical records is easier and faster. There are just a few more kinks in the process that need to be ironed out.

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