Electronic Health Records and Patient Safety

Converting from paper to electronic health records may clear out some office clutter; however, doing so will not, on its own, improve patient care and safety. Electronic health records (EHRs) and other health information technology come with their own set of safety issues. For example, EHR systems that do not fit well within the workflow of your office or facility are of great concern. When an EHR system interrupts the complex thought process of a physician or other system user with steps that seem unnecessary or intrusive, the workload actually increases and frustration ensues. This frustration can impair one’s ability to complete tasks and lead to the creation of unsafe alternatives or workarounds. For example, if a computerized provider order entry (CPOE) system prevents physicians from ordering the medication or test they prefer or limits their ability to document in narrative fashion, the physician may choose to use a paper system, thus, missing important safety alerts. At the other extreme, if the CPOE system generates too many safety alerts, the physician may experience “alert fatigue” and either ignore or override the alerts, again, missing information crucial to patient safety.

To manage these new risks we recommend the following:
• evaluate the workflow in your practice setting;
• seek input on workflow from all who will use or be affected by a conversion to EHRs;
• identify what you hope to accomplish by changing to an electronic health system.

Taking these steps will assist you in choosing a system that meets your needs and maximizes the patient safety benefits.

To learn more about choosing an EHR system, see Electronic Health Records: An Overview of the Risks and Risk Management Advice.

Kathryn E. Heagerty, BSN, JD – Risk Manager Ms. Heagerty graduated, cum laude, from Duke University with a BSN. She received her JD, cum laude, from Stetson University College of Law, also earning a Certificate of Concentration in Health Law. While at Stetson, she completed legal internships at the United States District Court Middle District of Florida and at University Community Hospital in Tampa. Ms. Heagerty’s legal experience includes assisting in the representation of plaintiffs and health care providers in medical malpractice actions. She speaks and writes on risk management topics and serves as the company’s CME Program Coordinator.