The Brave New World of Electronic Health Records

If you’ve been to the doctor lately, you’ve probably noticed the physician's increasing use of laptops and tablet computers, in addition to the PCs the office staff employs. Perhaps they type or otherwise enter data while you talk to them. Such practices are becoming the norm because of the burgeoning use of electronic health records, or EHRs, to store patient data rather than using the older paper-records system. In practice, it sounds great—computerized files are easier to correct and take up no space when compared to paper records. Also, a computer’s dynamic search capabilities should make it easier to find needed information, right?

It’s true that EHRs make data available more quickly. There’s no need to wait for a transcriptionist to enter a doctor’s notes into the system. However, it’s also true that data errors in records, and related malpractice lawsuits involving EHRs, are on the rise. From 2013 to 2014, the frequency of EHR-related lawsuits doubled.

The Problems That Generate EHR-related Lawsuits

Admittedly, the current number of medical malpractice lawsuits that invoke EHRs is fairly small—for now. But common causes for the suits keep recurring:

·“Information gaps” that omit or distort critical data. Words can be misheard or dropped by voice recognition software, creating uncertainty at best and errors at worst.

· Poor software design. One example is drop-down menus in EHR software inserting default values that are often not caught and corrected.

· Pure and simple human error. Several common mistakes have caused legal problems, including outdated or incorrect patient information mistakenly copied and pasted into the EHR (which can magnify errors); vital signs data from one visit copied repeatedly into a record without being updated; and data entry mistakes such as typos.

These three primary kinds of mistakes often produce diagnosis, treatment, and medication errors (not only mistakes in the drug prescribed, but also dosage slip-ups), which at least partially explains the rise of malpractice lawsuits related to EHRs. At the 2015 HIMSS conference, Keith Klein, a medical doctor and professor of medicine at the David Geffen School of Medicine at UCLA, described four cases in which judgments amounted to more than $7.5 million because an EMR’s data was shown to be untrustworthy in court.

Other legal risks with EHRs exist as well. Using EHRs makes data vulnerable to other legal hazards, such as the issue of hackers accessing sensitive information, as well as data breaches unrelated to hacking. Additionally, the sheer volume of information can make it difficult for medical personnel to follow a patient’s “story,” increasing the chances of mistakes. It has been compared to trying to drink from a fire hydrant.

What’s to be Done?

The road ahead for EHRs is not clear, but some of the risks unfortunately are, as we’ve shown here. Not only does EHR software need to become more robust (in geek-speak), but the law needs to catch up with current practices. Because EHRs are so new, comprehensive patient safeguards do not exist under the law. We will need to rely on both medical personnel to investigate when a patient’s data seem at odds with their observations, and on patients to speak up when something seems amiss. If the law does not catch up, and doctors and patients are not diligent, using EHRs could become a minefield of errors and legal snafus that lead to patient harm.

FEATURED LISTINGS FROM NOLO
Swipe to view more
NOLODRUPAL-web1:DRU1.6.12.2.20161011.41205