WIHI: Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines

Date: November 6, 2014


  • David Classen, MD, CMIO, Pascal Metrics; Associate Professor of Medicine and Consultant in Infectious Diseases, University of Utah School of Medicine
  • Frank Federico, RPh, Executive Director, Strategic Partners, Institute for Healthcare Improvement
  • Ann Bisantz, PhD, Professor and Chair, Industrial and Systems Engineering, University at Buffalo, The State University of New York

As the implementation of electronic health records (EHR) increases across healthcare, so has awareness of new patient safety risks that the technology has either introduced or exposed.  The very same EHR being counted on to improve communication, safety, and continuity of care across multiple settings and providers turns out to have features that can have the opposite effect. Getting a good handle on where the vulnerabilities lie is the first step toward coming up with solutions.

Some of the most prominent concerns include EHR systems that generate so many online warnings that clinicians and staff complain of “alert fatigue” and have come up with workarounds to avoid them. To save time, practitioners have also developed the habit of updating a patient’s EHR with a lot of copying and pasting, often forwarding medical information that no one has recently reviewed and that may contain inaccuracies. Computer programs that allow doctors to open up and work on multiple electronic patient records at the same time is another accident waiting to happen, according to some. When combined with being interrupted or distracted, it’s not hard to imagine all the mix-ups that can and do occur.

We’re in the middle of a learning curve to ensure the EHR doesn’t bring new harm to patients and facilitates, rather than disrupts, an organization’s reliable processes and patient safety culture.


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