This blog already contains several posts on the problems of using electronic health records (EHR) in hospitals. If you keep up with medical literature, as we must do in order to handle medical malpractice cases, it is striking that almost every week there is a new article about the perils of EHR. A recent one in Medscape, an online publication aimed at health care providers, summarizes the complaints.
The title: “8 Malpractice Dangers in Your EHR” is telling. It points out risks to a doctor of being sued because of EHR problems, but doesn’t mention that the “danger” isn’t just to the doctor, but to the patient! After all, unless a patient is seriously injured because of an EHR problem, there is no risk of a malpractice lawsuit in the first place.
The article summarizes the problems and perils into several major categories, including:
(1) Copying and pasting text, which can mean incorrect or outdated patient information is repeated and potentially utilized by later providers.
(2) The use or non-use of passwords to access the EHR computers, which means that providers may not access key information because they don’t have the password or, in the alternative, if no password is required the information can easily be hacked by outside personnel.
(3) Ignoring changes in clinical or medication data because it is “buried” in so much repeated information that it is overlooked.
(4) Focusing on the computer screen while in the exam room rather than focusing on the patient, and thus missing key clinical or history data.
The article also points out how the focus on electronic records increases the gap between patients and their doctors, and this widening impersonality can also lead to more risk of someone suing their doctor.
Ask any health care provider who uses EHR — and that is pretty much everyone in today’s medicine — and you will hear many more complaints about how the system works and doesn’t work in their practice. If you ask patients, they may not know how it is affecting them, until there is a bad outcome and an attorney finds out the EHR was a major factor in causing the harm. Ask a medical malpractice attorney, and you will get an entirely new list of EHR perils, mainly involving the difficulty of even finding out what clinical decisions were made, when they were made, and how they were communicated.
Another post on this blog will discuss “audit trails,” a key means by which attorneys travel down the rabbit-hole of EHR to understand what went wrong and how it injured their client.
