EMR glitches could increase providers' liability risk

While medical practices slowly but surely begin adopting electronic medical records, in part to close potential gaps in patient safety, two Case Western Reserve University professors are warning providers that EMRs are not mistake proof--and could even increase their risk of malpractice liability.

Physicians are largely unaware of the new risks they and their patients face if, for example, an EHR system contains software bugs, is too complicated or is implemented with insufficient user training, according to Sharona Hoffman, professor of law and bioethics and co-director of Case Western Reserve's Law-Medicine Center in Cleveland, and her husband, Andy Podgurski, professor of computer science at the university's School of Engineering, whose scholarly article is published in the Berkeley Technology Law Journal.

"Whether or not there is a software bug, in the sense of a clear error that causes a wrong output, the usability of the system may be lacking, and that may lead a user to make mistakes that have safety implications," Podgurski said.

Thus, the authors--known for their work promoting national EHR regulation--propose a uniform process for developing authoritative clinical practice guidelines, noting that EHR system purchasers may never know about product flaws because no regulation requires such disclosure, and some vendor contracts even prohibit it.

"If a computer problem causes an error in somebody's drug prescription, medication dosage or surgical procedure, that can be catastrophic," Hoffman said.

However, research supporting the positive links between electronic records and patient safety continue to abound. A recent survey of pediatricians from Houston and Cincinnati listed EMRs (along with better follow-up care and more collaboration with patients and their families) among the top three keys to reducing errors in diagnosis.

The researchers, whose work is published in the July issue of Pediatrics, suspected that EMRs might help physicians from missing diagnoses by offering better care coordination and information availability.

"Since this project was initiated [survey was administered between November 2008 and May 2009], major national changes related to electronic medical record use have occurred," said Dr. Hardeep Singh, a lead author and assistant professor of medicine and health services research at the Veterans Affairs Health Services Research and Development Center of Excellence and BCM. "The federal government has now incentivized the use of these systems and we are bound to see more physicians using them."

To learn more:
- read this article in Insurance Journal
- see the abstract from the Berkeley Technology Law Journal
- check out this piece in the Cherokeean Herald

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