Electronic Health Records Seen as Safety Trap for Doctors

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By James Swann

Your doctor’s electronic health record could be making you sick.

That’s one of the findings from a recent report by a leading medical association, which said EHRs have design flaws that could lead to medical mistakes and patient harm.

The current design of most EHR products is confusing and can cause physicians to make medical errors such as prescribing the wrong drug or lab test for a patient, the Aug. 28 report from the American Medical Association, Pew Charitable Trusts, and MedStar Health said.

Physicians have long complained about the administrative burden posed by EHRs. The assertion that the technology may negatively affect patient health is likely to renew calls for EHR changes.

The government needs to step up and require more rigorous EHR testing, Michael Hodgkins, chief medical information officer at the AMA, told Bloomberg Law. Hodgkins said the medical association would like the the National Coordinator for Health IT, the HHS agency responsible for certifying EHR products, to expand its testing requirements for electronic health records, which he called “pretty limited.”

Potential problems with electronic records affect a wide cross section of the health-care industry: A May blog post by a Department of Health and Human Services official noted that as of 2015, 96 percent of hospitals and 78 percent of office-based doctors were using electronic health records certified by the government.

The AMA has already been in touch with the ONC, as well as with the Joint Commission, about boosting requirements, Hodgkins said.

The Joint Commission accredits and certifies over 21,000 health-care organizations and could also serve as a good vehicle for improving EHR testing, Hodgkins said.

More rigorous EHR testing and certification would likely be costly for EHR vendors such as Chicago-based Allscripts and Epic in Verona, Wis. Vendors would have to revamp testing protocols and work more closely with end users like hospitals and physicians.

The report also cautioned that the EHR certification program can’t guarantee the safety of EHRs, Hodgkins said.

EHR developers should test new products in doctors’ offices to ensure physicians are able to use them properly before having them certified by the ONC, the report said.

Certification testing of EHRs should also focus on scenarios where a patient’s safety is at stake, the report said. For example, one scenario could determine whether an EHR would issue an alert if a physician ordered penicillin for a patient allergic to it.

The Electronic Health Records Association didn’t respond to a request for comment on the report. The EHRA represents leading EHR developers.

Critical Concerns

The report pinpoints several critical EHR concerns facing health-care providers, Robert Tennant, director of health information technology policy at the Englewood, Colo.-based Medical Group Management Association, told Bloomberg Law.

For example, the EHR industry has failed to test how physician use of EHRs is impacting patient safety, Tennant said. The current ONC certification process is also in need of a fix, Tennant said.

“We hope that this research leads to EHR developers voluntarily building safer and more user-intuitive software,” Tennant said. The report should also help shape the federal government’s role in promoting and deploying effective health information technology, he said.

Two-Way Street

EHR vendors and health-care providers will have to work together to improve EHR testing until the government takes formal action, Hodgkins said. EHR developers should be testing their products for any safety issues, and hospitals and physicians should keep testing those products after they’ve implemented a new system.

Hospitals and physicians also routinely customize or reconfigure an EHR system and fail to test the new system’s safety. Customized EHRs can be very different from the original version that was certified by the ONC, Hodgkins said.

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