Family physician and medical blogger Kenny Lin wrote of the error he almost made several years ago when he prescribed medication for one of his patients using his EMR system. He clicked the wrong choice, but caught his mistake before the patient left the office. Lin's assessment: "electronic systems only change the nature of the medical errors that are made."
Lin's experience is a sobering reminder of the vulnerabilities of EMRs. They are not and should not be touted as the panacea to the healthcare industry's medical errors and other problems. They should be viewed, as many advocates including David Blumenthal, MD, head of ONC, have said, as a tool to improve the quality of care.
Lin is absolutely correct when he says that EMRs are vulnerable to "incorrect entries, computer glitches and unauthorized access of personal health information." To be fair, however, paper records are not immune to incorrect entries and unauthorized access of personal health information. The difference is that with EMRs you have an electronic trail; you can audit what has happened in the system.
But this isn't really about paper versus electronic. This is about being aware of the vulnerabilities of EMRs. If you're a harried, sleep-deprived clinician, you are vulnerable to making errors period, whether you're writing out an order or inputting it into an EMR.
Again, EMRs are tools that are meant to help. There are a lot of processes and policies, including workforce, that need to be revised on both the industry-wide level and on the physician office and hospital system.
I'm not dismissing the vulnerabilities of EMRs. Developers and vendors need to continue to upgrade and improve the systems, and pay heed to problems that healthcare providers report. ONC and other entities should help guide what changes need to be in place outside of health IT.
As an industry, we all need to be mindful of the limitations of EMRs and how we can overcome those limitations.
Photo by neoliminal courtesy of Creative Commons license.
