EHRs may help prevent in-hospital adverse events

Hospitals using a "fully electronic EHR"--a system "in which all physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically" developed--recorded lower incidences of in-hospital adverse events, according to a new study in the Journal of Patient Safety.

The study, sponsored by the Agency for Healthcare Research and Quality (AHRQ), examined EHR adoption and occurrence rates of patient safety adverse events by analyzing patient discharges, using data from the 2012 and 2013 Medicare Patient Safety Monitoring system. The authors looked at patients 18 years of age or older who were hospitalized for acute cardiovascular disease, pneumonia or conditions requiring surgery.

The outcome measures were in-hospital adverse events, including hospital acquired infections, adverse drug events, general events and post-procedural events. The study sample included 45,235 patients at risk for 347,281 adverse events at 1,351 hospitals

The researchers found that patient exposure to a hospital with a fully electronic EHR correlated with 17 to 30 percent lower odds of having an in-hospital adverse event. For example, such patients who were hospitalized for pneumonia had 35 percent lower odds of an adverse drug event and 34 percent lower odds of a hospital acquired infection.

In a related blog post, Amy Helway, M.D., deputy director of AHRQ's center for quality improvement and patient safety, and Edwin Lomotan, M.D., medical officer and chief of clinical informatics at AHRQ's center for evidence and practice improvement, said that while the study didn't address which safety features were optimized or which apps had the greatest impact, its findings suggest that the EHR is associated with better coordinated care.    

"As of today, most hospitals and clinicians have embraced specific EHR applications and we continue to see implementation of more quality and safety features," they said. "EHRs can play a key role in preventing adverse events, and as this study suggests, adoption of EHRs can better manage the multiple tasks that prevent adverse events before they occur, keeping patients safer as a result."

EHRs have shown that they can improve patient safety and population health. However, they are not foolproof; they suffer from design inadequacies and user error that can adversely affect patient safety. Steps are being taken to improve EHRs and patient safety.

To learn more:
- read the study abstract
- here's the blog post