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Since there is no regulatory framework to monitor EHR system safety, these systems may This medical error could have been prevented if automated alerts had been activated. 16 In another case, a baby died from a massive drug overdose as a result of a transcription error that occurred when a handwritten order was entered into the computer system. 15 For example, a patient's treatment for cancer was delayed by several years because a setting in her physician's EHR system defaulted to an old normal Pap test result instead of the more recent abnormal results. While a primary goal of EHR implementation is the reduction of medical errors, reports of new types of errors directly related to EHR implementation that can compromise quality of care and patient safety have emerged. 13, 14 Although some of the studies cited in this article are several years old, recent literature continues to cite these studies. It has been suggested that the introduction of HIT, rather than leading to improvements in the quality of data being recorded, has led to the recording of a greater quantity of bad data. 12ĮHR Risks Adversely Impacting Information Integrity 11 Adverse outcomes associated with EHRs are not being systematically and consistently tracked.

There is no sense of shared accountability between system developers and users for product functioning.

10 Policies, usability principles, and best practices for proper EHR system use have not been widely and consistently adopted. 9 EHR certification does not guarantee that EHRs will be implemented and that they will work as planned. Currently there are no regulatory requirements to evaluate EHR system efficacy and safety. 8Īlthough EHR-related errors, and their actual and potential impact on the quality and usefulness of EHR documentation, quality of care, and patient safety, have been documented for years, much work still needs to be done to measure the occurrence of these errors, determine the causes, and implement solutions. 6 Although little published evidence quantifying the magnitude of HIT-associated risks exists, 7 as HIT products have become more intimately involved in the delivery of care, the potential for HIT-induced medical error, harm, or death has increased significantly. 4 Despite the promise of EHRs’ improving quality of care and patient safety, a growing body of evidence has found potential safety hazards associated with their use, sometimes referred to as “e-iatrogenesis.” 5 The emergence of EHR-related errors results in data being lost or incorrectly entered, displayed, or transmitted, leading to loss of information integrity. 3 (In this article, the terms HIT and EHR are used interchangeably and include electronic prescribing and clinical decision support.)Īdoption of HIT has failed to achieve projected benefits and cost savings because of shortcomings in the design and implementation of HIT systems, including safe and effective use of these systems. 2 Adoption of health information technology (HIT), including electronic health records (EHRs), is essential for the transformation of the current US healthcare system into one that is more efficient, is safer, and consistently delivers high-quality care.

1 The quality of healthcare across the continuum depends on the integrity, reliability, and accuracy of health information. US health spending far surpasses that of other countries, yet our healthcare system fails to regularly deliver high-quality healthcare.