EHRs lacking in adverse drug event detection

Many studies confirm that electronic health records enhance patient care, reduce costs or provide some other benefit. But sometimes a study reveals that EHRs--and, fact, the studies testing the EHR systems--have design flaws.

That's the conclusion of a recent study of EHR adverse drug event (ADE) detection systems published by the Journal of American Medical Informatics Association. ADEs, adverse patient outcomes caused by medications, are common and difficult to detect, and occur in 6.5 percent of hospitalized patients, which makes them a major threat to patient safety.

The researchers theorized that electronic alerts to detect ADEs showed promise, since they would be faster, cheaper, objective and more accurate than other detection methods, such as manual chart review. The study analyzed prior studies of electronic systems that automatically screened for ADEs from hospital pharmacy, laboratory, radiology and administrative departments.

The results were not positive. Electronic detections were only 50 percent accurate, and for some EHRs "quite low," according to the researchers.

Perhaps more tellingly, the researchers found that the studies reviewing the accuracy of electronic ADE alerts themselves were "limited," and warned that should be a more systematic approach to validating electronic adverse drug alert detection methods. The problems cited included the lack of standard ADE definitions and the failure to consider clinical priorities.

"In the development of new alerts, investigators and system developers should pay more attention to the relative prevalence of specific ADEs and focus on those which are most common and serious and use universal standards in ADE classification," the researchers recommended.

To learn more:
- read the study's abstract