Some clinicians view electronic health records as more negative than positive when it comes to patient safety, according to a new study in BMC Medial Informatics and Decision Making.
The researchers, from the University of York and elsewhere, wanted to determine how the implementation of an EHR system affects patient safety in England's National Health Service (NHS). Most patient safety information was coming from the U.S., whose health system is different economically, organizationally and structurally. They interviewed 19 NHS clinicians in a maternity unit at an NHS teaching hospital in the north of England during the first year of its implementation of an EHR in 2014.
They found that significantly more challenges with the system were reported than benefits, with clinicians reporting perceived and actual increased risks to patient safety. For instance, there were concerns that the clinicians would make inputting errors due to lack of typing skills. The interviewees also expressed concern that the data being added was less detailed and accurate, since it took longer to type.
There also were technical factors affecting safe use of the system. It was harder to find information due to its design, increasing the risk that patient information would be missed. The lack of flexible data entry methods, such as being able to draw diagrams, meant that nuances and details were left out. The system sometimes crashed or froze up, and most users were not authorized to edit data. In addition, there were not enough computers; those they had were placed at the opposite end of the ward from the patients, meaning that clinicians had to leave the patient in order to get to the computer.
The researchers made several recommendations, including more mobile computers if possible, opportunities for front line staff to voice concerns, and more training and technical support.
"[D]uring the first year of implementation there may be a period of increased risk to patient safety, as staff become accustomed to using the system," the researchers said. "Given the global focus on digitising health, it is important that organisations are aware of and do not underestimate the potential risks."
To learn more:
- read the study