Mounting concerns about the impact of electronic health records on patient safety have forced providers and developers to take a deeper look at some of the inherent flaws in their systems.
This year, EHR management topped the ECRI Institute’s list of top ten patient safety concerns, and experts have noted that most hospitals don’t have a formal health IT safety committee to address issues within EHRs. Including health IT team members in daily clinical safety huddles, where EHRs are a common concern, is one proven way to quickly and effectively address emerging issues.
But some of those defects could be resolved with simple changes to the way information is displayed. According to a report (PDF) released this week by the HIMSS Electronic Health Record Association, alert modifications, along with simple formatting adjustments, could have a sizable impact on patient safety.
Below are three highlights from the report:
- Decimals and commas help: EHRs contain a wide array of numerical formats. The consistent use of decimals and commas keeps users from misreading a medication dosage. For example, .5 mg can easily be misread as “five milligrams.” Reformatting to 0.5 mg provides more clarity.
- Drugs are confusing; don’t make it worse: Several organizations, including the Institute for Safe Medication Practices and the FDA recommend the use of “tall man” letters to distinguish look-alike drugs (bupropion and buspirone, for example). Building in this feature, either directly through the EHR developer or a content vendor, can limit confusion. Clear spacing between letters and numbers can also ensure patients are receiving the correct medication dosage.
- Visually distinguish abnormal lab results: Consistency and clarity are key here. Physicians need to be able to quickly pick out abnormal results, and EHRs can help by displaying irregular labs in bold, red lettering, or some similar unified display. Graphs should also demarcate the normal range for that patient.