A recent article in Outpatient Surgery, a publication for health-care providers, listed the top 10 technology problems that can result in patient injury. The top 5 are of special interest. They are

1. Alarm hazards: Inadequate alarm configuration policies and practices
2. Data integrity: Incorrect or missing data in electronic health records and other health IT systems
3. Mix-up of IV lines leading to misadministration of drugs and solutions
4. Inadequate reprocessing of endoscopes and surgical instruments
5. Ventilator disconnections not caught because of miss-set or missed alarms

As our health care system relies more and more on technology, the potential problems will multiply. Interestingly, much of the technology is intended to eliminate potential errors. The major example is electronic health records, which are now mandated by federal law, and which were intended to allow standardized record-keeping and much better access by off-site physicians and other providers. But not a week goes by when there is not another medical publication that describes the myriad of problems encountered in the use of electronic records.

The image of a doctor standing in a patient’s room and quickly flipping through the chart is now replaced by a doctor hunched over the computer at the nurses’ station trying to find key information buried in the duplicative and “cut-and-pasted” entries.

As the article points out, a major problem is incorrect data. That can be true even with the old-fashioned paper and pen entries, but the problem is that an error is often now reproduced and perpetuated in almost every entry. Thus, a mistaken reference to the patient’s left foot in a physical exam is then repeated over and over again in the electronic record, even though the problem is the right foot. Those of us who look at lots of medical records sometimes see a reference to a female patient, when the patient is actually male (or vice versa), and that same reference is then duplicated over many days of hospitalization.