Governmental pressure on hospitals, clinics and doctors to adopt EHRs is being blamed for some of the biggest medical risks patients face. It’s all due to data errors in the computer programs governing patient records.
According to The Legal Intelligencer, the Affordable Care Act (ACA) created what was called an incentive program to encourage healthcare professionals and institutions accepting payments from Medicare and Medicaid to install an EHR system quickly (1).
In examining this program, the harsh reality is a penalizing system since it reduces the payment to those who don’t have the EHR system in place. If “eligible” professionals accepting Medicare and Medicaid claims don’t comply with the regulation, they are penalized 1% of the reimbursement they ordinarily would receive from Medicare and Medicaid.
The possibility of malpractice grew exponentially with the mandate of EHR systems. In some cases, that fear of a monetary penalty resulted in a knee-jerk reaction by healthcare facilities and medical practices. In their rush to implement an EHR system, some did upgrades to existing systems, while others installed new systems and migrated their data (medical records).
Some installed software programs with flaws and glitches that compromised the integrity of patient data. In some cases, the patient data was lost or incorrectly migrated into the new system or not all data was populated into the patients’ records.
These errors have created EHR malpractice lawsuits (2). Surprisingly, many of these suits resulted in the doctor, hospital or medical facility being held liable instead of the EHR vendor or computer technician – all thanks to the contract specifics between the vendor and user.
Doctors Face Malpractice Due to EHRs Errors
In a recent article, “EHRs Are Full of Legal Risks”, published on the website for medical professionals, Medscape, there are other ways incorrect medical information might exist on a medical database (3).
Written as a warning to doctors, the article cites several concerns that many medical facilities are overlooking and are resulting in malpractice. Among these include some very disturbing possibilities, such as those pesky software bugs and flaws. Some EHRs fail to “populate the fields of other screens correctly, or authorized software upgrades may alter the presentation of historical data…”
To further complicate the possibility of malpractice, Medscape points out that HIPPAA (Health Insurance Portability and Accountability Act) states that it’s the healthcare provider, not the EHR vendor that’s responsible for “maintaining the integrity of the patient’s medical record.”
It goes without saying that a computer glitch could have life-threatening consequences for a patient. Other factors can play a compromising role in the integrity of a patient’s records.
There is also the danger of copying incorrect or outdated information. In addition, the length of a patient’s record resulting from this method of migration can obscure important medical information. Court cases have been won based on this practice that resulted in a patient’s disease going undiagnosed and treated, resulting in death.
Employees who download information from the Internet, especially videos and music can unknowingly leave a backdoor entrance to hackers.
One of the biggest potential problems in using an HER is input errors, mostly from attempting shortcuts the system was designed to perform or simply human error in checking appropriate boxes on a screen. Some of the auto-fill functions can also cause errors if the wrong letter is typed into the screen and the wrong information is automatically placed in the section.
There are many other ways that a patients’ data can be compromised or corrupted. Many physicians complain that the input process is slower and more time-consuming than the old way of hand-written notes. As a result, some doctors rush through the process, increasing the potential for input errors.
Others devise shortcuts that the software wasn’t designed to accommodate and data often isn’t populated into the patients’ records or notes don’t find their way into the proper fields and are overlooked.
Anyone who has worked with database software and migrating records understands that auditing of these records is a must to ensure accurate populating of all data fields. Even with this type of checks and balances, a record that is constantly being updated and altered becomes more and more susceptible to incorrect or corrupt data unless auditing and double-checking standards are in place and practiced.
A Harvard paper titled Patient Safety and Health IT discusses an analysis conducted on a “years’ worth of medical malpractice claims in its comparative database.” The analysis revealed “147 cases in which EHRs were a contributing factor.” (4)
Cause for Concern
These cases were the result of computer systems unable to “talk to each other”, improperly routed test results and input errors from typos as well as copying and pasting of data. The EHR related malpractice cases represented $61 million made in “direct payments and legal expenses.”
The possibility of such incorrect medical information showing up on individual records is something everyone should be cognizant of, especially when being admitted into a hospital or long-term care facility.
You can take steps to protect yourself by making sure any disease or health issue you have as well as medications you take or are allergic to are clearly showing on your record.
Ask and double-check whenever any new medicine or procedures are discussed. You are your best advocate when it comes to ensuring you receive the best possible medical care.
References & Image Credits:
(1) The Legal Intelligencer
(2) TSW: Study Reveals Most Medical Errors Are Unreported
(5) Wikipedia: Medical Records