Framework proposed for minimizing EMR safety problems

Phased approach could align with Meaningful Use stages, proponents say
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A team of experts from two Texas medical schools are proposing a framework for protecting patient safety when using electronic health records.

In a report published this week in the New England Journal of Medicine, the team from the University of Texas Health Science Center at Houston and Baylor College of Medicine proposes implementing the framework in three phases:

  • Addressing safety concerns unique to EHR technology, such as medication errors from mismatched coding or the impact on a clinic when computer systems go down.
  • Mitigating safety concerns arising from failure to use EHRs properly, such as bypassing computerized physician order entry, or problems arising from errors built into complex clinical-decision support systems.
  • Using EHRs to monitor and improve patient safety, for example by programming systems to detect errors of omission or misidentification of patients, and to generate files recounting safety problems.

The phases could be tailored to the phases of EHR implementation and related Meaningful Use requirements, the authors said.

"National EHR-related patient-safety goals are needed to address current problems with existing EHR implementations and failures to leverage current EHR capabilities," the authors concluded, adding that the goals "must be technically feasible, financially prudent, and practically achievable within current constraints and be accompanied by specific guidance on achieving them.

Writing earlier this week in iHealthBeat Perspectives, hospital administrator Christina Thielst lamented that EHRs "often don't have health education materials that are understandable and actionable for patients with basic or below basic health literacy."

But, she said in her commentary, audio, video, graphics and simulated environments can present the information in a more understandable way.

"Evidence-based communication practices for safety include making the patient part of the team, advocating for the patient, engaging the patient and closing the loop with communications," she wrote. "Emerging technologies offer opportunities for new and innovative strategies that will transform the way health care institutions and professionals communicate with their patients and with the rest of the care team.

To learn more:
- read the NEJM piece
- here's a related announcement from Baylor
- check out Thielst's commentary

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