EHRs may reduce claims by improving safety, quality

Malpractice claims dipped dramatically among Massachusetts physicians after they began using electronic health records (EHRs), according to new research, although it’s not clear whether the record-keeping was connected to the decline in claims.

Despite its limitations, however, the research provides more evidence that electronic health records “improve quality and safety and, as a result, prevent adverse events and reduce the risk of malpractice claims,” says study co-author Steven Simon, MD, an associate professor with Harvard Medical School in Cambridge, MA, and an internist with VA Boston Healthcare System.

In the new study, researchers tracked malpractice cases for 275 physicians who were surveyed in 2005 and 2007. Of those, 33 were targeted by malpractice claims. Forty-nine claims related to alleged medical malpractice that took place before the physicians adopted EHRs, and two occurred after.

Of the 189 physicians surveyed in both 2005 and 2007, a total of 27 (14.3%) were named in at least one malpractice claim. Overall, 33 of the 275 physicians from multiple surgical and medical specialties who responded in 2005 and/or 2007 incurred a total of 51 unique claims; 49 of these claims were related to events occurring before EHR adoption, and two were related to events occurring after EHR adoption. The use of EHRs was associated with a lower rate of malpractice claims, with an estimated relative risk of 0.16.

The researchers estimate that medical malpractice claims were about 84% less likely after EHRs were put into place.

The study says factors other than EHRs could account for the difference in claims. Physicians who used the records, for example, could be early adopters whose style of medicine was less likely to spawn malpractice claims. Also, Massachusetts made major changes to the state’s healthcare system in 2006.

“We found that the rate of malpractice claims when EHRs were used was about one-sixth the rate when EHRs were not used. This study adds to the literature suggesting that EHRs have the potential to improve patient safety and supports the conclusions of our prior work, which showed a lower risk of paid claims among physicians using EHRs,” the authors wrote. “By examining all closed claims, rather than only those for which a payment was made, our findings suggest that a reduction in errors is likely responsible for at least a component of this association, since the absolute rate of claims was lower post-EHR adoption.”

Implementation of EHRs “may reduce malpractice claims and, at the least, appears not to increase claims as providers adapt to using EHRs,” they wrote.

The full report is available online at http://tinyurl.com/72sgdhb.