The switch from paper charts to Electronic Health Records (E.H.R) was supposed to make the health care industry more efficient, safer, and even less expensive. With the ability to quickly access millions of healthcare files and build upon a patient’s health history over time, the idea posed a solution for eliminating preventable errors to provide a higher quality of streamlined care.
In 2009, the U.S. government introduced the American Reinvestment & Recovery Act, which included a federal mandate for healthcare providers and hospitals to adopt and demonstrate “meaningful use” of electronic medical records by the deadline of January 1, 2014. Incentives were given out to providers who were compliant with the transition, and multiple new careers were even born out of the mandate to help health care providers manage the work.
However, concerning reports made nationwide have revealed some unexpected and dangerous consequences of E.H.R.s that are putting patients at risk. According to Kaiser Health, subpar systems and digital medical negligence have been plaguing E.H.R. programs for the past 10-years. These are the most concerning risk factors of E.H.R.s that are costing patients their lives.
Please note, we are not providing health advice. As safety and health advocates, we believe it’s crucial to stay informed about your health and current issues that could affect it.
Patients are bearing the ultimate price from the negative consequences of digital health records. One tragic example includes a story highlighted by Kaiser Health of a woman who died of a brain aneurysm that should have been detected.
Two months prior to her death, Annette Monachelli visited her doctor to report a pain radiating from the top of her head- a symptom pointing to the possibility of an aneurysm. No tests were done to rule out the condition and minimal steps were successful in easing her pain. Two months later, Annette entered the emergency room, where she died a few days later.
When her husband hired an attorney to look into her death, Annette’s medical records indicated that her doctor had ordered a head scan to rule out an aneurysm at the same appointment she first reported the pain. The test could have caught the bleeding to her brain had it been performed. The problem: the request for the test was never transmitted through the E.H.R. software system.
Annette’s case opened up the door for additional investigations into the pitfalls of E.H.R. programs and found that she was far from the only patient who had been put at risk due to poor oversight and system errors. Medications issued without start or stop dates, dosage errors, failed transmissions of test requests, missing scans, and incomplete charts were only a few of the mistakes found as federal investigations picked up speed.
Patient health records are there to guide treatment and avoid interventions that could cause harm. When errors in record-keeping occur, patients can be misdiagnosed, fail to begin treatment for optimal prognosis, or undergo unnecessary tests that put their health at risk. Current E.H.R. systems are allowing patient’s information to slip through the cracks, and patients are sustaining serious and fatal injuries as a result.
Lack of Oversight
The expectation for mandating E.H.R programs nationwide was to allow patients to be seen at any healthcare facility in the country with access to their full medical history. But the process of switching from paper to digital records has been anything by seamless.
Kaiser Health reports that lack of oversight into rolling out the E.H.R. programs resulted in a number of systems on the market that are unable to exchange information. Instead of a few programs that are similarly designed with the ability to communicate, now there are hundreds with different codes and program needs. This makes the ability to transfer secure information difficult and has resulted in critical health information getting in the process.
Researchers have found that E.H.R. programs are being used to file false claims that result in kick-backs for providers and insurance companies while sticking patients with high costs and possible health risks. Certain aspects of E.H.R. programs can be easily manipulated, resulting in the generation of recommended treatment plans that only include the highest cost procedures and medications.
Kaiser Health highlighted one case settled in May 2017 that discovered a physician who had made tens of thousands of dollars by promoting a drug that patients didn’t necessarily need. Allegedly, the doctor was able to get away with the behavior due to easily customizable features and the E.H.R. program’s failure to use standard drug and procedure codes recognized by the health care industry.
Lack of Reporting Errors
The lack of data showing the number of people who have been adversely affected by E.H.R.-related medical errors is partly because there are minimal reports to analyze. According to the Kaiser Health article, several E.H.R. software companies created imposed contractual “gag clauses” that discouraged hospitals and health care providers from speaking out when they experienced errors. These “gag clauses” have prevented the reporting of safety issues, fatal errors, and massive software glitches that have spiraled out of control.
Hundreds to thousands of patients are believed to have been affected by E.H.R. errors. Most patients have no idea, and some have already lost their lives as a result.
If you have been to the doctor’s office recently, you may have noticed that your physician spends more time on their computer or tablet than they do face-to-face with you. Unfortunately, most doctors are doing this with the best of intentions.
Doctors are reporting that half of their day is now spent filling out online forms, selecting from pulldown menus, and typing in notes. Because there are so many online forms to fill in with E.H.R. software, doctors who do not want to make errors in patient’s records are forced to type during appointments. Emergency room doctors alone are estimated to make 4,000 clicks per shift!
The massive amount of information required from E.H.R. programs has doctors reporting higher levels of fatigue and burnout. Both of these risk factors have been linked to increasing the possibility of medical errors while decreasing the personal reaction needed with patients to provide quality care.
Check Your Records!
Marylanders can start advocating for their health by checking the accuracy of their health records. The Office of the National Coordinator for Health Information Technology provides a number of resources to help patients check for errors in their health history. Some of the most crucial details patients should look at include:
- Name, address, phone number, emergency contact information, and email contact.
- All information regarding your medication history and current medications.
- The accuracy of the concerns you expressed at your appointment.
- The possibility of misunderstandings that could have occurred between you and your doctor.
- Tests and procedures that have been requested or completed.
- Costs for completed procedures.
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