Today, the majority of physicians offices and hospitals have switched to electronic health records, hoping that both medical professionals and patients will benefit from the efficiency and communication offered by more coordinated health care. But as with any new technology, electronic health records are a double-edged sword, creating new opportunities for risk even as they promote better medical decisions.
Electronic Health Records Lead To Rise In Malpractice Settlements
In a new report from medical malpractice insurance firm The Doctors Company, researchers say errors related to electronic health records (EHR) are being implicated in a rising number of malpractice settlements.
Between July 2014 and December 2016, the company writes, a total of 66 closed malpractice claims involved electronic health record mistakes. More than six years earlier, between 2007 and 2010, only 2 of the company’s resolved settlements were related to electronic health records – just 0.2% of the insurer’s total recorded claims for that period. While still a low proportion, EHR-related problems now account for around 1.6% of the firm’s closed settlements.
EHR Design & Implementation Creates Medical Pitfalls
Why is a technology designed to improve patient outcomes, and encourage best practices among physicians, becoming a bigger source of risk in medical offices and hospitals across the country? The Doctors Company identified a host of issues related to electronic health record systems themselves, either their implementation or design:
- 12% of closed claims – a “fragmented” electronic health system, in which the program’s design records reports and notes on the same patient in multiple locations
- 11% of closed claims – technology failures, whereby associated technical systems, like a radiology lab’s computer, is unable to communicate with the EHR program
- 6% of closed claims – routing problems, in which data from one area of the practice isn’t transmitted to all floors or areas in which the patient is seen
- 6% of closed claims – EHR system provided checkboxes, but no space for text, leaving provider notes incomplete
- 5% of closed claims – electronic health record system did not provide alerts to notify doctors that ordered tests were not yet performed, or that their results had not yet been updated
- 1.5% of closed claims – use of two or more incompatible EHR systems
We’re still in the early days of electronic health records. It’s likely that many of these mistakes are happening because hospitals and doctor’s offices are still in the process of transferring their paper records to a computer system. 15% of closed settlements in the insurer’s database involved some form of incomplete transfer, as administrators inaccurately shifted patient notes on paper to the computer.
In other cases, however, it’s clear that some issues are “baked in” to electronic health systems as they are currently designed.
Another problem that is only certain to grow is that, as EHR systems become more popular, incompatibility issues will increase. Some hospitals currently use two or three EHR programs to serve their needs, but not all of these systems are designed to play nice with each other.
The problem will probably be compounded as even newer systems enter an already-swollen market. Around 67% of health care providers use an electronic health record program today, Practice Fusion reports. The number of companies providing EHR systems, meanwhile, has doubled over the last four years, growing to an estimated 1,100 in 2017.
The Brave New World Of Malpractice
We could be entering a brave new world of medical malpractice, where medical errors have as much to do with algorithms and user interfaces as they do with scalpels and heart monitors. It could be that, in the future, we see more and more medical error lawsuits slip into the domain of product liability, where legal standards are often even higher.
But human errors are also prevalent in The Doctors Company’s analysis. In fact, more often than not, an EHR-related mistake comes down to careless use of a computer system, not the computer system itself. In 14% of the firm’s closed EHR-linked settlements, doctors had simply copy-and-pasted a patient’s progress report from one day to the next, despite worsening symptoms and troubling test results.