EHRs and safety on WIHI

Madge Kaplan writes:

The next WIHI broadcast — Optimizing Safety with the Electronic Health Record: The Latest on Glitches and Fixes from the Frontlines — will take place on Thursday, November 6, from 2 to 3 PM ET, and I hope you'll tune in.

Our guests will include:

• David Classen, MD, CMIO, Pascal Metrics; Associate Professor of Medicine and Consultant in Infectious Diseases, University of Utah School of Medicine
• Frank Federico, RPh, Executive Director, Strategic Partners, Institute for Healthcare Improvement
• Ann Bisantz, PhD, Professor and Chair, Industrial and Systems Engineering, University at Buffalo, The State University of New York

As the implementation of electronic health records (EHR) increases across health care, so has awareness of new patient safety risks that the technology has either introduced or exposed. The very same EHR being counted on to improve communication, safety, and continuity of care across multiple settings and providers turns out to have features that can have the opposite effect. Getting a good handle on where the vulnerabilities lie is the first step toward coming up with solutions, which is why we hope you’ll join us for the November 6 WIHI: Optimizing Safety with the EHR: The Latest on Glitches and Fixes from the Frontlines.

The list of problems is growing, but some of the most prominent concerns include EHR systems that generate so many online warnings that clinicians and staff complain of “alert fatigue” and have come up with workarounds to avoid them. To save time, practitioners have also developed the habit of updating a patient’s EHR with a lot of copying and pasting, often forwarding medical information that no one has recently reviewed and that may contain inaccuracies. Computer programs that allow doctors to open up and work on multiple electronic patient records at the same time is another accident waiting to happen, according to some. When combined with being interrupted or distracted, it’s not hard to imagine all the mix-ups that can and do occur.

Guests on the November 6 WIHI have a lot to contribute to our discussion. Dr. David Classen is nationally renowned for his work on safety and is one of the lead authors of a 2011 Institute of Medicine report on health IT and patient safety. Among other things, the report speaks to the need to understand new electronic tools in the context of a “larger sociotechnical system that also includes people — such as clinicians and patients — organizations, processes, and the external environment.” David will be joined by Ann Bisantz, who brings a human factors lens to our topic, crucial to analyzing how health care providers are being challenged by the EHR and health IT today and the need to develop habits consistent with safety goals and best care. IHI’s Frank Federico has been looking hard at the unintended consequences of a number of new health care technologies, including the EHR, and will work with WIHI host, Madge Kaplan, to guide our discussion.

We’re in the middle of a learning curve to ensure the EHR doesn’t bring new harm to patients and facilitates, rather than disrupts, an organization’s reliable processes and patient safety culture. I hope you will join us on November 6.

You can enroll for the broadcast here. We'd also appreciate it if you would spread the word about the show via Twitter.