Electronic health records, or EHRs, are a form of digitized medical records that are intended to allow physicians to access a patient’s medical history quickly and from any room in the building. The transition from paper records to EHRs has been lauded by hospital administrators and politicians alike as a way to cut costs, improve efficiency and prevent medical errors.
While EHRs may accomplish these things in the near future, a recent report from the Pennsylvania Patient Safety Authority suggests they haven’t achieved their goals yet. In fact, EHRs may have been responsible for over 300 medication errors in Pennsylvania hospitals in the past decade.
The errors seem to be related to the record’s default settings, which are used to quickly fill out standard information in health records. When a patient receives a new medication, for example, doctors often apply the default setting to the health record, which automatically lists the most common dosage for that drug. The duration of the medication period and the duration of certain therapies and procedures can also be entered through default settings.
The problems arise when doctors fail to fill out forms completely, which causes the EHR to automatically fill in the blanks with default information. If this default information does not match the doctor’s intentions, a medication error can result. Similarly, doctors may forget to change the default settings to suit the patient’s needs. In some cases, doctor-submitted information can even be overwritten by default values, a problem that can easily lead to improper care.
The Pennsylvania Patient Safety Authority found 324 incidents of a medication errors related to default settings on EHRs. The vast majority of these caused no harm to patients, but in two instances, the patient was injured badly enough to require additional hospitalization. One contracted a fever when an antibiotic was improperly discontinued, and the other never received a necessary antidiuretic.
Something as trivial as a health record mistake should never lead to an adverse effect for patients. When individuals walk into a hospital, they trust that they will receive safe and proper health care. Hopefully, Pennsylvania’s electronic health records can be improved to ensure that this trust is not broken again.
The Clinical Advisor, “Incorrect EHR settings cause medication errors” Ann W. Latner, JD, Sep. 17, 2013