Medication Errors and Patient Electronic Health Records

Electronic health records are supposed to improve the safety of healthcare.  But a new study shows they are missing a significant amount of potentially serious medical errors.

An electronic health record is a computerized version of the traditional patient chart.  EHRs go back as far as the 1960s and were pioneered by college medical centers.  As technology became more affordable, EHRs were adopted widely across the healthcare industry.

Today, the EHR industry is big business, with a multitude of private companies selling their proprietary hardware and software to doctors and hospitals across the country.

Besides making patient care more cost-efficient, the conventional main selling points of electronic health records include:

• Improving patient care – allowing instant and remote access to key patient information
• Improving medical care coordination – allows all physicians providing care access to a patient’s history, including emergency room doctors
• Improving patient diagnoses

In short, EHRs are touted as a tool to reduce the number of medical errors that harm patients.

A federal website focused on healthcare technology and EHRs specifically mentions how EHRs can limit serious medication errors, by listing a patient’s history of medications and issuing alerts when prescribing mistakes are detected.

In theory, an EHR can prevent a patient from suffering a potentially fatal allergic reaction by warning a doctor about an incompatible medication, for example.

EHRs Miss One Third of Patient Medication Errors

But a recent survey counters that argument, finding an alarmingly high rate of serious medical errors undetected by electronic health records. The authors report that EHRS missed about a third of all medication mistakes.

The study (“National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018”) was published online in late May by the Journal of the American Medical Association. The research specifically focused on EHRs and how well and how often they uncovered “adverse drug events.”

Using private vendor-produced EHR systems employed by about 2,300 U.S. hospitals between 2009 and 2018, the researchers ran nearly 8,700 patient record simulations through them.  The scenarios were derived mostly from actual disastrous patient experiences, including death or significant injury.

Types of Serious Drug Errors

Researchers issued the records to the hospitals, which downloaded them into their electronic systems.  The records included detailed patient histories, diagnoses, and lab results, reflecting those of real-life hospital patient admissions.

Each of the orders had some sort of medication error, including:

• Potential drug allergy
• Wrong dosage
• Wrong drug administration route

In 2009, the electronic health records found serious medical errors a little more than half the time.  Over the course of 10 years the EHRs improved a bit.  By 2018, the study found that the EHRs flagged 66% of medical errors embedded in the patient simulations – still missing one-third of all potentially fatal healthcare mistakes.

While there was improvement, the researchers concluded there remain serious patient safety issues with electronic health records. Human user error is always a constant.

But other concerns with EHRs include a lack of imposed federal standards for medical software.  The study found that less than 70% of the systems met basic safety standards. And hospitals that don’t regularly update their software may endanger their patients. Miscommunications may occur when EHRs from different facilities cannot adequately “talk” to one another.

Today’s electronic health records are just one possible source for serious medical errors, estimated to be the third-leading cause of death in the United States. If you were severely injured or had a family member die unexpectedly while receiving medical care, consult with a medical malpractice lawyer to conduct a thorough investigation and pursue just compensation on your behalf.

The choice of a lawyer is an important decision that should not be based solely on advertisements.

Authored by Gray Ritter Graham, posted in Articles June 30, 2020