Risks of poorly designed electronic health records

Posted Mar 28, 2018 by Tim Sandle
There are many advantages with electronic health records, from avoiding lost files to portability. However, if records are not well-designed this can put patients at risk.
The use of an electronic medical prescription service.
The use of an electronic medical prescription service.
MC4 Army (CC BY 2.0)
There are a range of reasons why electronic health records are increasingly being adopted by medical services. These include the end to bulky paper records, which need to be stored, managed and retrieved. In addition, digital health records provide easier access to clinical data, and they can be used to establish and maintain effective clinical workflows.
Moreover, some reports suggest that e-records lead to fewer medical errors, improved patient safety and stronger support for clinical decision-making. Furthermore, the data captured can be used in surveys and to support various clinical studies and initiatives. Outreach workers can also gather and analyze patient data that enables outreach to discreet populations.
There is also the issue of portability, and the opportunity to interact seamlessly with affiliated hospitals, clinical practices, laboratories and pharmacies. Errors can also be minimized through more legible, complete documentation together with accurate, streamlined coding and billing.
However, things can also go wrong and the more serious issues but patients lives at risk. One potential drawback of electronic health records is the risk of patient privacy violations. This is, according to research, an increasing concern for patients due to the increasing amount of health information exchanged electronically.
A further example of the risks facing patients comes from The Verge. This is based on an in-depth review of safety hazards in Pennsylvania and the mid-Atlantic, which discovered medical errors linked to electronic health records.
The Pennsylvania and the mid-Atlantic findings related to 557 errors reported to the Journal of the American Medical Association ("Electronic Health Record Usability Issues and Potential Contribution to Patient Harm"). The main risks are attributable to specific usability issues, which relate to poor design.
An example cited is where an e-record allowed a clinician to record a child’s weight in kilograms instead of pounds. The consequence of this could have resulted in dangerous overdoses of medications being given, since many doses are measured out by weight.
The solution, according to the researchers is with quality-by-designing, ensuring that medical staff form part of the design teams and then to repeatedly test electronic health records before they go live in the clinical setting.