Risk managers should sign off on EHR system
Risk managers should be directly involved with choosing an electronic health record (EHR) system and also with building the system, says Robert Hitchcock, MD, FACEP, a practicing ED physician in Dallas and an Emergency Department Practice Management Association (EDPMA) board member. He also is vice president of T-System, a Dallas-based company that consults on regulatory issues.
Many EHRs are purchased as a technology platform on which the user builds an EHR according to their needs. In those cases the risk manager needs to have the same signoff on that purchase and design as the clinicians have for the clinical workflow, Hitchcock says. In addition, the patient safety issues related to EHRs might be amplified when a hospital or health system adopts a large system for the organization all at once.
"I think people may need to reconsider this all-in’ model that is a single data platform model, which really on the back end isn’t a single data platform. That creates issues you thought you were avoiding with that model," such as the incompatibility problems often found when using data platforms are known to be different, he says. "Turning away from that opens the opportunity to choose systems that are more appropriate for the medical applications and environments in which they are used."
Above all, Hitchcock says, the risk manager needs to be alert to potential for EHR-related safety threats and be ready to address them just as thoroughly as with any other patient safety issue.
"Probably the most valuable thing a risk manager can do is to develop a root cause analysis program that is specially tailored to gathering the information necessary from the EHR issues for that analysis," he says. "They also need to give the EHR system the same benefit that they give people in a root cause analysis: not blaming them for the error, but looking for the root cause that allowed it to happen. People who implement and maintain EHRs can be very defensive, and they don’t want a snap judgment that the system doesn’t work."
- Robert Hitchcock, MD, FACEP, Vice President, T-System, Dallas. Telephone: (972) 503-8899.