When electronic health records are hard to use, patient safety may be at risk
New research suggests that hospital electronic health records (EHRs) that are difficult to use are also less likely to catch medical errors that could harm patients.
As clinicians navigate EHR systems, alerts, reminders, and clinical guidelines pop up to steer decision making. Yet a common complaint is that these notifications are distracting rather than helpful. These frustrations could signal that built-in safety mechanisms similarly suffer from suboptimal design, suggests the new study. Researchers found that EHR systems rated as being difficult to operate did not perform well in safety tests.
“Poor usability of EHRs is the number one complaint of doctors, nurses, pharmacists, and most health care professionals,” says David Classen, M.D., the study’s corresponding author and a professor of internal medicine at University of Utah Health. “This correlates with poor performance in terms of safety.”
Classen likens the situation to the software problems that led to two deadly Boeing 737 MAX airplane crashes in 2018 and 2019. In both cases, pilots struggling to use the system foretold deeper safety issues.
“Our findings suggest that we need to improve EHR systems to make them both easier to use and safer,” Classen says. He collaborated on the study with senior author David Bates, M.D., at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, and scientists at University of California San Diego Health; KLAS Enterprises, LLC; and University of California, San Francisco.
The research appears in the September 11 issue of JAMA Network Open.
Experts estimate that as many as 400,000 people are injured each year from medical errors that occur in hospitals. Medical professionals predicted that widespread use of EHRs would mitigate the problem. But research published by Classen, Bates and colleagues in 2020 showed that EHRs failed to reliably detect medical errors that could harm patients, including dangerous drug interactions. Additional reports have indicated that poorly designed EHRs could be a contributing factor. More