Do EHRs Actually Kill People?
Computers are not infallible. Their mistakes are called “bugs” or “software glitches” and just like the nurse or the medical records clerk sometimes placed the wrong piece of paper in the chart, Electronic Health Records (EHRs) can, and do, corrupt medical records. Incorrect, incomplete and indecipherable medical records can lead to injury and even death. But does it really happen?…
On the Health Care Renewal blog they are engaging in what I think they know are rather creative mathematics, to project hundreds of thousands of injuries per year if, and when, EHR adoption really takes off…
Between January 2008 and February 2010, the Huffington Post identified 237 reports in the voluntary incident reporting FDA database related to health information technology (HIT), including 6 deaths and 43 injuries. However, a closer look reveals that only a small fraction of these reports are actually related to EHRs per se…
Most reports involve picture archiving and communication systems (PACS), medication dispensing systems, blood banks and other FDA regulated equipment. Out of the 6 reported deaths (2 of which occurred in 2006), one was related to a PACS system latency, another to human error in labeling an x-ray cassette and another to a hospital pharmacy system. 2 deaths were attributed to system wide failures of computerized physician order entry (CPOE) and one to lack of intuitiveness in display of notes. As to injuries, out of the 43 reported, I could only count 17 directly related to EHR software and most have to do with CPOE.
Full article by Margalit Gur-Arie at her blog, On Healthcare Technology.
I suspect this is not a big problem. But it’s helpful to be reminded that mistakes in EMRs can be fatal for patients.
I think whether these sysptems are safe or not depends on who is using them and how they use them.
Health information technology encompasses far more than just EMR. Hospitals already have pharmacy robots that drive themselves from the central pharmacy (locked) to the nursing floor where nurses dispense medications. Diagnostic scans are already stored digitally and can be pulled up remotely.
The problem we currently face with EMR is that it’s difficult for a doctor to face you while talking and — at the same time — enter information on an EMR. Just as in other industries, the appropriate use for technology will evolve over time with some glitches.
I’m prepared to believe that they actually kill some people. Maybe more people than we care to acknowledge.
I don’t know if they will kill people or not. I do know, that since my PCP started using one, there seem to be important omissions in my records. Nephrectomy on the wrong side, Penicillin allergy missing, as was the Sulfa allergy. Stroke on the wrong side, along with a number of other medical conditions omitted or wrong. I’ve gone over it with them, 3X now, yet the info doesn’t get corrected.