Healthcare News & Insights

EHR risks identified from malpractice claims analysis

87463237In 2012, 44% of U.S. hospitals had at least a basic electronic health records (EHR) system. Not surprisingly, that number will grow as EHRs offer many benefits such as improving quality and safety, and reducing costs. Unfortunately, they also come with some major problems thanks to human error and technology glitches. 

These are errors and glitches that could cost patients their lives and hospitals millions of dollars in malpractice claims. For example, a provider who is in a rush enters the wrong medication in a patient’s file and she is given the wrong medication, which causes a life-threatening reaction. Or another example is a computer system crashes and nursing notes for an entire shift are lost, which also compromises patient care.

Anyone who helps run or works in a hospital can see both of these situations happening.

Take action

The key to preventing issues like those mentioned above is taking action.

CRICO, the patient safety and medical malpractice insurer for Harvard medical community, is doing just that by expanding its proprietary coding system to capture EHR-related problems that contributed to patient harm, according to a Patient Safety & Quality Healthcare (PSQH) article.Then the Massachusetts-based company guides the hospitals, physicians and other providers how to address these vulnerabilities in their systems.

The new coding system allows CRICO to:

  • pinpoint clinical elements that can lead to medical error
  • recognize historical and current trends, and
  • drive successful risk management efforts.

Vexing vunerabilities

When the insurer recently analyzed a year’s worth of medical malpractice claims in its database, it uncovered 147 cases where EHRs were a contributing factor. Some of the problems that were revealed included copying and pasting mistakes, computer systems that don’t communicate properly with each other, test results that weren’t routed properly and data entry mistakes. When direct payments and legal expenses were all totaled for these 147 cases, the bill was $61 million.

CRICO’s system revolves around its  Comparative Benchmarking System (CBS), which features 275,000 open and closed cases from more than 500 hospitals and 125,000 physicians from Harvard affiliates and CRICO Strategies partners around the country. CBS can analyze and trend data, as well as target solutions.

So which EHR vulnerabilities were most vexing?

Incorrect information wins the No. 1 spot. It was a factor in 20% of the 147 cases. This category includes:

  • Data entered into the system wrong — For example, a patients height may be in inches, but is recorded in centimeters which throws off the body mass index.
  • Incorrect conversions — Let’s say data is entered as 2.5, but the computer auto-converts it to 25 without the user noticing. This then becomes a medication error when the provider delivers the higher dosage.
  • Data entered in wrong file or field — It’s easy to pull up the wrong patient file and enter someone else’s test results in it. It’s also easy to lose your place in a patient file and enter information in the wrong field. These types of errors can haunt a patient for years and years without being caught.

Other vulnerabilities hospitals have to deal with when it comes to EHRs are conversion issues, which were a contributing factor in 16% of the cases. This often happens when paper files are being converted to electronic files. For example, a patient develops a medication allergy in the midst of the conversion, and the new allergy doesn’t get included in the computer file.

Finally, technology problems cause issues with medical errors. This can include:

  • Routing failures where test results aren’t sent to the hospital unit where the patient is located
  • computer crashes that lose data, and
  • computer systems that aren’t compatible even in the same hospital.

 Avoiding errors

While there is often a rush to implement EHR systems to meet deadlines, remind your organization that your doing this to provider better, safer care.

Here are three tips from EHR Intelligence that’ll help providers avoid common EHR mistakes:

  1. Have all your providers double check the name on the screen to make sure they are entering the information in the correct patient file. All the files look the same so it is easy to lose track of whose record you are working in. Double checking takes only a small amount of time, but it could save many lives.
  2.  EHRs are equipped with a number of alarms that are there to alert users of possible mistakes, such as patient allergies, medication interaction, and much more. Require all your providers to read all alerts to ensure patient safety isn’t compromised.
  3.  It’s a given: Providers in hospitals are busy people. And while cutting and pasting information may seem like a huge time saver, it should be avoided at all costs. For auditors looking for potential fraud, this is a major red flag. Not to mention the fact that one small mistake can be can perpetuate over multiple visits if wrong information is copied.

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