Electronic Health Records (EHR) are still in their infancy, and show significant promise. As with any new technology, however, there are still bugs and errors that can only be discovered through use and error reporting. In the context of treating patients, those errors can be deadly. Despite being federally mandated in many instances, the federal government has little oversight authority over them and their manufacturers.
A 2011 Institute of Medicine report found poorly designed EHRs were causing dosing errors, failures to detect life-threatening illnesses and delayed treatments because of poor human-computer interactions or data losses. In some cases, the errors had led to serious injuries and deaths.
For instance, after a 2-year old child was brought into a Baltimore emergency room, her weight was recorded as “35”. With no notation of pounds or kilograms, the EHR automatically converted the child’s weight to kilograms, resulting in a prescription dose more than double what she should have been prescribed at discharge. Two days later, the child was rushed back to the hospital after she slipped into a coma. Thankfully, she was revived and treated successfully. This example highlights the importance of error reporting standards and a need for proper oversight.
EHR providers are not required to publish or maintain a database of safety concerns, so doctors are often unaware of potential issues with the systems. The Institute of Medicine report suggested creation of a NTSB-like agency that would oversee EHRs and a centralized registry to catalog problems. Four years later, nothing has happened. Likewise, EHR systems typically make it impossible to capture screenshots for error reporting and diagnosis. Secrecy clauses in EHR contracts require the system manufacturer’s permission before sharing screenshots – preventing the free flow of potentially helpful information.
Critics say little is expected to change until EHR vendors no longer control the federal committees on EHR safety.
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