Friday, June 15, 2012

More Discussion On EHRs Patient Safety And So On. This Debate Must Be Worked Through Properly.

The following appeared a little while ago.


Electronic health records are being used in hospitals and doctors’ offices. So how are they doing? Do the E-records protect and promote patient safety?

Globe Staff / April 30, 2012
The patient who had come to see Dr. Eduardo Haddad had complicated problems — he was obese and diabetic with pulmonary hypertension. As Haddad reviewed the 50-year-old man’s medications, reading from a long list saved in the patient’s electronic health record, a window popped up on Haddad’s laptop. Two of the drugs, when taken together, could make the patient drowsy, it warned.


Haddad, an independent nephrologist in a two-doctor office in Lawrence, calls himself “old-fashioned.” He still keeps a bank of paper records in the receptionist’s office, but the electronic records system he uses each day is advanced. There are tools to screen for adverse drug interactions like this one and prompts to help him make choices about tests and treatments.
Haddad bought the “Cadillac system” last year, after trying a more basic system, and joined a growing body of physicians adopting the new technologies. One in 10 doctors who work outside hospitals in the United States began using electronic health records in 2011, helped along by the promise of $27 billion in incentives from the federal government.
As of the end of last year, 35 percent of such doctors had a system that performed at least basic functions, including ordering of prescriptions and storing doctor notes and test results, according to one in a series of studies on the topic published in the latest issue of the journal Health Affairs.
The technology is spreading, the result of years of fierce, well-funded advocacy aimed at soothing doctors’ concerns about the hassle and cost of the systems. To date, $146 million in incentive payments have been distributed to doctors and hospitals in the state to help pay for installation, training, and upkeep, according to Bridget Scrimenti, spokeswoman for the Massachusetts eHealth Institute, part of an independent state agency working on the issue.
Now, some involved in health information technology say it is time to focus more attention on making sure the systems are safe.
“In 2012, the debate can not be, should we or shouldn’t we” use electronic records, said Dr. Ashsh Jha, associate professor of health policy at Harvard School of Public Health and an author on one of the Health Affairs studies. “The new question is, how do we do it well? How do we not cause harm? . . . That’s the more compelling question and one for which we essentially have no data.”
Lots more here covering some of the more recent discussion on the topic.
This is a very useful summary of a range of recent discussions in the area of EHRs and patient safety.
This question is really the biggie!
“The new question is, how do we (use EHRs) do it well? How do we not cause harm? . . . That’s the more compelling question and one for which we essentially have no data.”
I would add to that how to we insure that technically the systems we use are robust and have safety built in to the greatest extent possible.
This is a work in progress.

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