Between 2010 and 2018, EHR-related claims in medical malpractice increased from 0.35 percent to 1.39 percent.
System technology and design issues or user-related issues contributed to a rise in EHR-related claims between 2010 and 2018, according to an analysis from the Doctors Company.
The pace of these claims grew from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018.
“EHRs are typically contributing factors rather than the primary cause of claims, and the frequency of claims with an EHR factor continues to be low,” analysts said. “Still, as EHRs approach near-universal adoption, they may become a more prevalent source of risk.”
The team found that 12 percent of EHR-related claims from 2010 to 2014 were caused by a technology failure, while seven percent occurred because the EHR lacked alerts or failed to send alerts.
Top user-related issues included copy/pasting, EHR conversion issues, and users entering incorrect information.
Researchers also identified which specialties receive the highest percentage of claims where EHRs are a factor. Family medicine and internal medicine were in the lead, at eight percent, followed closely by cardiology and radiology at six percent. General surgery and emergency medicine had the lowest percentage of EHR-related claims at three percent.
Injuries occurred in seven percent or more of all claims between 2010 and 2018, the group noted, and of those injuries, adverse reaction to medication or death were most prevalent in EHR-related claims. Twenty-five percent of deaths occurred due to an EHR-related issue, as well as 23 percent of adverse reactions to medications.
EHR-related issues also caused a need for surgery in 15 percent of claims, emotional trauma in 14 percent of claims, and undiagnosed malignancy in 13 percent of claims.
Of the allegations included in claims involving EHRs, diagnosis-related allegations represented nearly one-third.
These results align with much of what the industry has seen since the rise of the EHR. While the technology has undoubtedly benefitted care quality and efficiency, EHRs have also brought new, unprecedented challenges around data entry, physician burnout, and perhaps most notably, patient safety.
In March 2018, the ECRI Institute named EHR system workarounds, lack of health IT use safety, and poor internal care coordination as top patient safety concerns for healthcare organizations. Researchers noted that in order to ensure patients are safe, organizations must ensure their EHRs are well-designed and usable.
“It is not only how we use it in daily workflow, but also how we use it effectively by optimizing the benefits and reducing the risks,” said ECRI Institute Patient Safety Analyst and Consultant Robert Giannini.
The Doctors Company analysts gave tips for avoiding EHR-related claims, suggesting that clinicians avoid copying and pasting except when describing the patient’s past medical history. The group also recommended that physicians contact their IT departments or vendors if providers notice that the auto-populate feature in EHRs is causing erroneous data to be recorded.
Additionally, researchers said that clinicians should review their entries after making a choice from a drop-down menu and review all available data and information before treating a patient. To facilitate better communication between doctors and patients, the analysts suggest that physicians relocate computers so that their back is not to the patient and the patient can view the screen.
Going forward, it will be critical for organizations to recognize and mitigate the possible risks of EHR use.
“As a foundation, practices should have processes in place to monitor EHR issues and prioritize the need for EHR redesign based on risk. Identifying common EHR-related pitfalls and establishing risk mitigation strategies to minimize the chance of patient harm are important results of closed claims studies,” researchers said.
Date: September 02, 2019
Source: Ehr Intelligence