Wrong-patient order entry is a constant threat to patient safety. A team at Brigham and Women’s Hospital in Boston launched a project to add patient photos to the electronic health record. Two years later, the error rate had decreased by 35%.
Increased mortality rate in some hospitals led to new IRB monitoring and oversight
February 18, 2021
A clinical trial that involved studying electronic health record alerts for acute kidney injury seemed to be minimal risk to both the researchers and the IRBs that approved it. However, when two hospitals involved in the study reported an increased mortality rate, the researchers and the IRBs reconsidered what is truly minimal risk in these types of studies.
Clinical decision support (CDS) is meant to improve care quality by providing helpful alerts and advice to the electronic health record user. However, too often the result is an annoying proliferation of pop-ups that only frustrate clinicians. When the CDS system interrupts too much with alerts that are not useful, the result can be counterproductive. Clinicians routinely dismiss alerts. In the process, they may ignore those alerts that are useful, say researchers and hospital leaders.
Once someone concludes an emergency physician changed the medical record after a bad outcome, credibility (and likely the case) is lost. If there really is a valid reason to correct the electronic health record, clinicians should consult their facility’s policies and procedures regarding such corrections.
Electronic health record (EHR) issues are coming up in malpractice lawsuits against ED providers. Seven such cases were included in a recent analysis of 216 closed claims occurring from 2010 to 2018 in which EHRs contributed to injury.