EMRs may yet realize the massive value proposition their fans imagine, but before they get there hospitals still have to roll down a bumpy road. One threat that continues to loom over hospital EMRs — even if CIOs succeed at battling their high cost and complexity — is the distinct possibility that they will generate new categories of malpractice risk.
With EMRs being increasingly targeted in medical malpractice suits, hospitals and doctors need to be prepared for attacks of this kind. According to a data review by physician-owned med mal insurer the Doctors Company, EMRs were a part of med mal litigation in just 1% of a sample of suits closed between 2007 and 2013, but the frequency doubled between 2013 and 2014 alone, according to a report in Politico. That still only adds up to 2% of cases, but experts expect the number of EMR-involved medical malpractice suits to climb rapidly.
What’s more, trying to bury the mistakes by altering medical records can be a serious mistake. For example, notes an article in Medscape, the documentation which serves as a shield against malpractice accusations can also reveal details of when suspicious changes have been made. While clinicians may not always remember this, EMRs make changes in records after care has been given very easy to trace, something which can end up as quite damning if a patient care outcome is poor.
One particularly common trouble spot for EMR-related errors is self-populating templates, which, while they make life easier for doctors by capturing a patient’s recent medical history, can also create grounds for serious misunderstandings or medical errors. For example, at a conference attended by Medscape editors, one speaker told the story of a template which generated text saying the patient had had hip surgery — but the patient had actually had a spinal procedure.
Other mistakes EMRs can cause include faulty voice recognition, misinterpretation of drop-down menus, reliance on outdated or error-ridden records and typos that generate medical errors.
However, organizations that are prepared can avoid many of these errors. In an effort to do so, some hospitals and health systems are studying how technologies like EMRs will fit into their workflow. These facilities and systems are creating human-factor teams that conduct simulations in hopes of catching error-causing issues with EMR use before such errors become an issue. While such teams are not common — though they should be! — a report in iHealthBeat notes that the Society for Simulation in Healthcare had identified at least 165 simulation centers in the U.S. as of summer 2014.
Studying what impact a complex health IT system like an EMR will have on a healthcare staffers seems like a sensible and even brain-dead obvious move. But if less than 200 of the 5,000-odd hospitals are doing so, the healthcare industry has a lot of work to do before it can truly say EMRs are safe.
