Why Are Electronic Health Records Error-Prone?

Why Are Electronic Health Records Error-Prone?

Electronic health records (EHRs) were designed to provide better patient care and tracking, empower healthcare staff, save resources, and ultimately - make medicine safer and more efficient.

They can also enable researchers to discover the most effective disease treatments by using the massive amounts of data contained within. Being truly portable, EHRs could aid patients seeking treatment or professional opinion by allowing them to instantly share their medical histories.

Is this staggering potential of EHRs indeed manifested in today’s healthcare? Does it increase productivity, eliminate redundancies, and empower clinical work? 

We at Wemedoo highlight once more that, despite being nobly conceived, EHRs are inadequately conceptualized, implemented, and used. As a result, many errors occur regularly, leading to operational inefficiency and frustration among healthcare workers, even increasing the occurrence of burnout.

What Exactly Is Going on With EHRs?

The evidence states that EHRs have been underperforming in terms of tracking medication and laboratory results, as well as in information accessibility and usage. Even more confusing is that due to the complexity of the systems’ architectures and implementation practices, the origins of these shortcomings are often hard to pinpoint, so they can be successfully eliminated.

The patient medication listings have been proved to be unreliable – the documents would frequently show withdrawn drugs as current and newly prescribed ones would not appear. Moreover, the EHRs occasionally show one patient's medication profile alongside a physician's note for another patient, making it easy to misdiagnose or give a wrong prescription. In many cases, prescriptions lacked appropriate start and end dates, thus allowing under- or overmedication to occur. In addition, the EHRs systems often failed to keep track of lab results reliably, thus increasing the risk of inadequate treatment.

The EHR users frequently criticize the reporting system, specifically about the lack of automatic transfer of previously inputted data. From a system usability perspective, users complained about a high click load, lack of visibility, and the fact that many useful system features could not be viewed or accessed at the same time.  Furthermore, EHR users recorded many features unavailability issues, due to system crashes.

There have also been multiple reports of patient injury as a result of inappropriate alarm management and staff’s “alert fatigue”, which occurs when healthcare staff are overburdened with useless warnings and disregard the rare relevant ones.

On the other side, the systems’ design complexity causes so many bugs that as soon as one is fixed, another appears. Because the processes are usually so puzzling, errors frequently fall into the "grey area" of culpability. It can be difficult to distinguish between human error and technology flaws. Too often, a new EHR installation finds itself repeating the same errors and blunders as the previous ones.

The question is, are today's EHRs systems destined to fail from the start because their initial design was to solve reimbursement challenges?

Reorienting EHRs to the User

The trouble comes from the fact that the users sought flexible solutions and ended up with having to adapt rigid EHRs.

We at Wemedoo believe that EHRs should be individually adapted to clinical teams, which is a prerequisite for personalized medicine. In this way, we lay the groundwork for meaningful insights that will satisfy all parties involved.

In order to serve the user's needs in healthcare, EHR vendors, healthcare systems, and frontline healthcare workers should collaborate so that everyone understands the interaction of technology and users. Only this way, we can build a system that meaningfully complements healthcare work.

Wemedoo’s Take on the EHR Potential

It is crucial to shift the focus to medical data and ensure system interoperability. Future-proof access, such as this, would instantly eliminate errors, improve data quality, increase efficiency, and make everyday work easier for EHRs system users. Our EHRs approach contains structured medical data in its core, enables interoperability, and generates meaningful data sets. In this manner, we are able to overcome obstacles and strive to realize EHR’s full potential.

Stay with us, as we share our opinions on the evaluation of safety and usability methods, as well as on creating a clinical information system guideline.

REFERENCES:

  1. KHN [Internet cited: November 29, 2021]. Available from: https://khn.org/news/death-by-a-thousand-clicks/
  2. Patient Safety  Network [Internet cited: November 30, 2021]. Available from: https://psnet.ahrq.gov/perspective/new-insights-safety-and-health-it
  3. Simone Fischer, David L. B. Schwappach     , Reinhold Sojer, Esther Kraft. Efficiency and patient safety of hospital information systems. Available from: https://saez.ch/article/doi/saez.2021.20332