Ex-hospital nursing exec: Sharing EHR concerns led to termination

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A former hospital nursing executive says she was fired for reporting safety concerns about the facility’s electronic health record system.

Autumn AndRa, who in April was let go as chief nursing officer of Sonoma West Medical Center in California, claims in a lawsuit that the hospital’s Harmoni EHR system mixed up information for patients--for example, drug orders for one patient would appear on charts for another--according to The Press Democrat. The system also failed to display code status information, the article notes.

What’s more, the lawsuit says, many of those concerns were overlooked because the EHR’s creator, Dan Smith, donated and loaned millions of dollars to Sonoma West. Smith also serves as president of the hospital’s board of directors, according to the article. The lawsuit says Smith “retaliated” against AndRa and other employees who shared concerns about the technology.

Both Smith and Sonoma West CEO Ray Hino did not respond to requests for comment on the lawsuit from The Press Democrat. Hino, however, said that the EHR system was not dangerous and that no patients had been harmed as a result of its use.

Some industry stakeholders believe EHRs contain persistent software design problems. For instance, in an editorial published in December in BMJ Quality and Safety, Ross Koppel, M.D., of the University of Pennsylvania, argued that data in EHRs often is “defeated” by pop-up and drop-down lists that hide screens, alerts that obscure the screen, lost information and lack of interoperability.

“Reporting errors is essential, but so many errors are unknown, are attributed to poor implementation or user incompetence, and are made difficult to report by clunky mechanisms, legal concerns and normative pressures,” Koppel wrote.

The National Institute of Standards and Technology, last fall, published a new guide aimed at making EHRs more usable and thus safer. The guide offers recommendations to eliminate “never events” and associated patient harm by proactively addressing and mitigating the root causes of user errors from EHR design and implementation issues.

To learn more:
- read The Press Democrat’s article