Room for error: EHRs in the ER pose safety risks

Fast-paced environment, barriers to usability create new hazards

As electronic health records (EHRs) become a part of healthcare's "new normal," particularly in the emergency department, experts are concerned the new status quo is introducing more opportunity for medical errors, according to Kaiser Health News.

Medical errors are already the nation's third-leading cause of death, and widespread adoption of EHRs has created new ways for mistakes to be made, such as a nurse entering the wrong symptoms or a doctor clicking on the wrong number and overprescribing a medication.

In ED settings, KHN notes, the pace is so fast that many healthcare workers must power through processes they may not have had sufficient time to learn; in other cases, ED-based EHR programs previously were developed independently of the hospital's main system, but are being replaced by newer, unfamiliar hospital-wide systems.

Further complicating matters, many systems only allow users to edit one patient record at a time, which means doctors could make errors and have no way to keep track of them. Increased use of EHRs has, however, resolved safety hazards such as potential miscommunication due to misread handwriting, according to the article.

However, part of the problem is that system design reflects the wishes and needs of administrators or tech leaders rather than doctors, according to Robert Wachter, interim chair of the University of California San Francisco's department of medicine.

"It's one thing to have a computer, and informaticists on your staff, or have a doctor come in and look at this [particular design feature]," Wachter told KHN. "It doesn't get into this issue of what does it look like to be using this system at 4 in the morning, when you have nine other patients and a trauma patient running into the ER, and your beeper's going."

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