The article EHR safety goes to court discusses a hospital system suing an EHR provider over lack of support due to several safety issues. The issue is complicated by the fact that one provider was purchased by another and then the hospital contracted with a third party. Both claim breech of contract and the hospital system states that patients were harmed.
How were they harmed? There were errors in tracking of patient locations, discharge medications, and there was a general inability to properly use the Computerized Order Entry system (CPOE). These suits demonstrate that factors such as lack of usability, poor interfaces, poor training, and poor support, inevitably lead to errors. Compound that with the prevalent practice of having non-clinical, non-computer savvy, individuals input sensitive and tricky clinical data, and there is an ever-present recipe for disaster. Why can’t clinicians be counted on to input the data themselves? Because clinicians really don’t have the time or capacity to deal with poorly designed systems that do not function smoothly and intuitively; caring for patients, rather than nursing IT systems, is their main priority.
The article states: “For years, many patient safety advocates have warned that EHR systems carry numerous potential risks due to their poor design and the ease with which data entry errors can lead to medical mistakes. “ The reality is that highly pressured providers have to make multiple clicks, leading to an exponential rise is the potential for error. Rarely are real-time checks and balances built in, so that a person in-putting data has little, if any, verification, that “STAT ORDERS,” for example, were received and/or acted upon.
Anyone who has attended a risk management or critical incident committee meeting in the E HR era is well aware of the many system based medical errors that arise because of the functionality or lack of functionality of the programs and people interacting with them. Humans !
System-Based Medical Errors” inevitably lead to litigation that pits provider, hospital, and vendor against one another in a complex legal battle. In general, of course, there is no easy resolution as each side can easily point to the weakness of the other parties.
Moreover, lawyers, doctors, and healthcare systems can count on the fact that there will be competing vendors waiting in the wings with baited breath to take over any system wherein complaints are rising. In this case Epic took over a Cerner client; but in others Cerner has taken over an Epic client. This juggling occurs across the board. It is almost (but not quite) as bad a politics. There are promises, promises. Oh! The promises. Most often disregarded (or masked) is the fact that experience shows the same complaints regarding the old system will appear in the newly installed system in short order. The political metaphor aside, it is not unlike the story of Sisyphus; the Greek Titan who rolled a huge stone up the mountain, only to find that the stone rolls back down the mountain; Sisyphus again rolls the stone up the mountain; then down it comes; and so on, and so on, and so on. Indeed this circular manner of problem followed by so-called-solution, followed by reemergence of the problem, and again and again is sadly the way of healthcare IT in 2016. Sad, for sure.
Bottom line is that with the recent publicity that the third leading cause of death is medical error (a claim that most well-respected authorities feel is without solid basis) there will be evermore scrutiny of the different parties involved. The solutions (user-friendly programs, easy interfaces, easy navigation, national based CPOE and interoperability designed databases, etc.) have been elucidated in previous blogs.
Xpress Technologies Electronic Health Record, Practice Management, and Billing were fundamentally designed by providers for providers. This really makes a difference.