How EHRs Prevent Adverse Events and Improve Patient Safety

EHRs Improve Patient SafetyHealth information technology (HIT) includes methods and applications that enhance clinician decision-making and communication. Electronic health records (EHRs), for instance, have changed the way documentation is done and medical transcription services are delivered. Studies have found that EHRs can also prevent adverse events and improve patient safety. Positive experiences have been reported for cardiovascular, surgery and pneumonia patients as well as for physical therapy patients.

A 2016 study found that up to 91% of EHR adopters said that EHR use made records more readily available at the point of care, and compared to non-adopters, significantly more EHR adopters agreed that using EHRs allows them to deliver better patient care (71% vs. 54%).

An AHRQ-funded study published in The Journal of Patient Safety found that cardiovascular, surgery, and pneumonia patients whose complete treatment was captured in a fully electronic EHR were between 17 and 30% less likely to experience in-hospital adverse events. The researchers found that a fully electronic health record led to:

  • 35% lower odds of adverse drug events, 34% lower odds of hospital-acquired infections, and 25% lower odds of general events for patients hospitalized with pneumonia
  • 31% lower odds of post-procedural events and 21% fewer general events for patients hospitalized for cardiovascular surgery
  • 36% lower odds of hospital-acquired infections among patients hospitalized for surgery

Likewise, Exscribe reported on a 2013 study by the National Ambulatory Medical Care Physician Workflow Survey which provided some interesting insights into EHR use by physicians:

  • 70% maintained that the lab reminders and medication alerts on their EHR contributed to preventing potential harm to a patient
  • 45% said that a medication alert in their EHR had helped avoid a potentially serious medication error
  • 47% reported they felt positive toward their EHR and believed that specific features helped them deliver improved preventative care

This report also highlights the outcomes of a study by the Carnegie Mellon University Living Analytics Research Centre which found that EHR adoption reduced adverse patient safety events by more than 25%. It also led to a 30% decrease in negative medication events, and a 25% decrease in events or complications related to procedures, treatments, or tests.

The report also discussed the specific benefits of EHRs for orthopedic patients. Patient portals allow them to deliver their diagnostic material such as X-rays, MRIs, and other types of imaging. This overcomes the challenges of having to mail, fax, or transport this material from one area to another. By improving patient engagement, EHRs give orthopedic patients better control over their condition, allowing them to manage it better and improving the potential for a positive outcome. EHRs also enhance communication among physicians and specialists as well as between physicians and patients. This promotes patient safety and trust.

While some recent studies have revealed EHR use-related patient safety threats, experts point out that there is a way around. Berkshire Medical Technologies reported on a study released in October 2017 which found that poorly-designed EHR systems combined with human error contributed to patient safety issues during the past decade. The article lists the measures that clinicians and HIT developers can take to address this concern:

  • Limit use of EHR shortcuts such as the copy-paste tool: Physicians tend to use the copy-paste functionality to reduce the time spent on their computers. However, researchers in a 2017 JAMA study found that using copy-paste functionalities could increase the risk of patient harm through the entry of repetitive, outdated, nonspecific, or inaccurate EHR clinical data into physician notes. The researchers said that this would undermine the utility of the notes and lead to clinical errors. They recommended healthcare organizations and HIT developers take measures to restrict the amount of copied information in physician EHR notes. The authors also recommended locking certain sources of information to prevent copying altogether. For example, blocking the copy-paste function when providers are entering data into a blood bank information system can prevent errors related to blood transfusions.EHRs Patient Safety
  • Avoid complex EHR interfaces: The best type of EHR interface is one that is simple and uncluttered, according to a report from Pew Charitable Trusts. Unwieldy or overly-complex EHR designs can confuse clinicians, and make it difficult for them to find information. This will negatively impact their productivity and also affect patient care. The researchers pointed out that, “Important design principles include knowing what users need for a simple interface, removing complexity, using simple and clear terminology, emphasizing key elements, and using color effectively to draw users to important areas.”
  • Refrain from excessive EHR customization: The authors of the Pew Charitable Trusts study also advise organizations against customizing EHRs. Though customizations may be requested by a health care facility or staff, it is risky to implement such changes as they may not have undergone rigorous testing by the provider or the EHR developer to detect potential safety concerns.
  • Improve physician education on EHR use: Human error is responsible for many EHR-related errors. Educating physicians on how the software works can reduce errors and patient safety risks.
  • Standardize EHR system design: Researchers also recommend improving health IT standardization to reduce EHR-related problems. Standardization can reduce liability risks.

For accuracy in EHR data entry, providers can rely on medical transcription outsourcing. Simplifying EHR design will make it easier for physicians to view the information in a clear, concise, and straightforward manner. Ensuring clear and accessible EHR data can reduce the chances of medical errors and EHR-related patient safety risks.