Electronic files coming out of a computer

A comprehensive new study about electronic health records concluded safety performance has "increased modestly" over a 10-year span, but variations among hospitals and vendors provide opportunities for improvement.

The national trends study of electronic health records, or EHRs, used data from a test administered by the nonprofit health industry watchdog Leapfrog Group. The test "uses simulated medication orders that have either injured or killed patients previously to evaluate how well hospital EHRs could identify medication errors with potential for patient harm," according to the study, published in late May at JAMA Network Open.

"Despite the broad adoption of electronic health record systems across the continuum of care, safety problems persist," the authors wrote. The study found that a "wide variation in the safety performance of operational EHR systems remains across a large sample of hospitals and EHR vendors."

Electronic health record systems "are large, complex, and constantly evolving, yet they are largely unregulated with respect to safety."

The study said it found "heterogeneity" among EHR vendors, "suggesting that both technology and organizational safety culture and processes are important contributors to high performance." The study also found "the number of institutions taking the test has increased 10-fold."

Commenting on the new study, Raj Ratwani, director of the MedStar Health National Center for Human Factors in Healthcare, said the results showed "slow EHR safety progress that is not uniform across all hospitals." Ratwani said the results "provide a clear indicator that safety improvement efforts should be accelerated and be a central focus of all stakeholders, including health care organizations, EHR vendors, patients, and federal agencies."

The authors offered several proposals to hospitals, vendors and policy makers for the consideration of improving the safety performance of electronic health records. Among the recommendations: an annual safety evaluation and greater safety-information sharing between hospitals and EHR vendors.

"Continuous assessments are also critical to identify unanticipated problems that may occur as systems are updated and customized. They should also share these results with their EHR vendor to help these vendors create safer products, as safety is a shared responsibility between vendors and hospitals," the authors wrote.

Mike Scarcella (mscarcella@alm.com) is a senior editor at BenefitsPRO parent company ALM in Washington. Twitter: @MikeScarcella.

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Electronic health record safety has 'increased modestly,' new study asserts

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