A new study has concluded that as EHR use has become ubiquitous, the number of medical malpractice claims in which EHRs contributed to injuries is continuing to rise. While the absolute number of claims is still relatively small, the problems involved are quite common, suggesting we haven’t seen the worst of this yet.
The study, which was conducted by medical malpractice insurer The Doctors Company, looked at EHR-related med mal claims that closed between 2010 and 2018.
Researchers found that the number of claims in which an EHR was involved has climbed dramatically, from just seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. Interestingly, EHR issues usually weren’t the primary cause for the claims. When they were a factor, most of the EHR-related issues were related to system technology and design issues and user-related problems.
Researchers found that the top system technology and design issues were related to electronic systems and technology failure. Meanwhile, the most common user-driven issues were driven by incorrect information, hybrid health records or EHR conversion and problems created by pre-populating or copying and pasting.
They also found that of injuries taking place in 7 percent or more of claims, adverse medication reactions and death were more prevalent. Diagnosis-related allegations represented almost one-third of the total EHR-related claims studied.
To address the problems identified by the study, The Doctors Company suggested the following:
- Physicians shouldn’t be copying and pasting other than when inputting past medical history details.
- If they notice that their EHR’s auto-population feature causes erroneous data to be recorded, physicians should promptly get in touch with their vendor and/or IT department.
- If auto-populated information is incorrect, physicians should note this and add the correct information to the documentation.
- After making a choice from a drop-down menu, physicians should review entries to be sure their choice was correct.
- Physicians should make a point of reviewing all available data and information on a patient prior to treating them, as many injuries take place due to a failure to take that information into account.
- Physicians should relocate the computer so that their back is not to the patient, and the patient can view the screen.
- It’s wise for physicians to remind the patient that they are listening carefully even if they are typing during the appointment.
- Physicians should summarize or read the note to demonstrate that they were indeed listening during EHR-based note-taking sessions.
For perspective, it’s worth checking an unrelated list of EHR-related medical malpractice concerns published in 2017.
That list cites some issues identified by The Doctors Company, copy and paste, use of templates and missing information, as potential sources of injury, but also alert fatigue and clinical decision support alerts.
At the time this was mostly speculative, but unfortunately, as the recent study demonstrates, the problem of EHR-related harm has become a real concern. We should probably spend more time on identifying EHR-related risks preventing such injuries before they become even more common.