Electronic health records and other forms of healthcare information technology may be riddled with inherent risks that can harm patients, according to an alert from the Joint Commission.
Confusing human-computer interfaces, poor health IT support and design issues that lead to miscommunication are among many concerns cited in the alert released Tuesday from the nation's largest hospital accreditation organization.
Though EHRs play an increasingly critical role in the healthcare space, they “introduce new kinds of risks into an already complex health care environment where both technical and social factors must be considered,” according to the sentinel alert.
Between Jan. 1, 2010, and June 30, 2013, there were 120 health IT-related events reported by participating hospitals, the report states. About 33% of the errors had to do with human-computer interface usability issues, 24% were related to health IT support communication and 23% resulted from design or data issues relating to clinical content.
Examples cited include a chest X-ray being mistakenly ordered and performed for the wrong patient when the incorrect room number was clicked, and a physician accidentally choosing the wrong method of injection from a drop down menu.
The Joint Commission began issuing sentinel alerts in 1996 to make hospitals aware of practices that can lead to serious adverse events, such as surgical items being left inside of patients, misconnected medical tubes and overwhelming amounts of medical alarms.
The report issued Tuesday is the 54th such alert, and builds on a 2008 alert that focused on the safe implementation of health information and converging technologies.
Several recent studies have pointed to the potential for complicated, confusing EHRs that pose serious patient-safety threats. A 2014 Veterans Health Administration study found, for example, that more than half of the adverse events reported in 100 closed safety investigations resulted from issues such as system failures, computer glitches and false alarms. Another quarter involved input error or a misinterpretation of displays.
Hospitals should keep in mind the potential of complications when going live with new EHR and other health IT systems, safety experts warn. Avoid ambiguous language that can make drop down menus confusing, for example, they advise.
The Joint Commission also outlined several recommendations, including limiting the number of patient records that can be displayed on the same computer at one time and a comprehensive systematic analysis of each adverse event to determine if health IT contributed to the problem.
EHRs can improve healthcare quality and safety through their ability to access important medical history data, provide clinical-decision support tools and facilitate communication among providers, the Joint Commission stated.
But, they must be well-designed and appropriately used. “The potential for health IT-related harm will likely increase unless risk-reducing measures are put into place,” the commission said.
