EHRs Among Today's Top Health IT Hazards

Patient/data mismatches in EHRs and other health IT systems, distractions from mobile devices, and interoperability mishaps are just a few of the current health IT hazards that could harm patients. So says a recent report by ECRI Institute, which offers publications and consulting on patient safety, quality improvement, risk management, and more.

"Top 10 Health Technology Hazards List for 2013" is the sixth annual health IT hazard report published by ECRI. Jim Keller, vice president of health technology evaluation and safety at ECRI, said in an interview with InformationWeek Healthcare that the institute looks to various databases, clinical literature, trends across the industry, and clinicians and health IT professionals to narrow down its hazard list and determine the top 10.

Wrong EHR information, distractions from mobile devices, and interoperability failures are new additions to this year's list. To illustrate the danger of inaccurate EHR data, Keller said to imagine lab results entered incorrectly into a patient record. "Then, it's possible for a clinician to take action on those lab results and treat the patient incorrectly."

[ For the latest development on Meaningful Use, see Meaningful Use Stage 2 Rules Finalized. ]

"... [O]ne of the things we emphasized in the report is to make sure when you're purchasing a new EMR system or [upgrading] a system, you're testing these products and [are] looking for the possibility data can be associated incorrectly with the wrong patient file," Keller continued. Additionally, he said, organizations can avoid this problem by having patient association processes in place to improve the accuracy of the information they're gathering. One way to do that? Barcoding.

Smartphone distractions are another key hazard and is growing due to the adoption of BYOD programs, Keller said. By way of illustration, he said, "Look at your personal use of emails. A lot of us are inundated with messages; some of it is noise and some is legitimate. It's easy for a regular user of email to miss an important email message, and that same scenario can happen with clinicians relying on laptops and tablets for clinical information." Mobile distractions can also occur while a caregiver talks with a patient and becomes preoccupied with information popping up on his mobile device, whether personal or not. "Like texts messages or tweets," Keller said. "We talk to organizations about implementing policies for how clinicians use their digital devices in patient interaction scenarios…some hospitals will allow for smartphones to be used, but they can't have personal data on them…BYOD is like the Wild West."

Lastly, the communication between mobile devices, and the communication sent to an EHR thereafter, can pose a serious threat to patients, said Keller. One example, he said, is communicating alarm data from a ventilator to a patient monitor. The purpose of this transmission of data is to display information on the patient monitor from the ventilator, yet, the alarm status from the ventilator, for example, can be changed or even dismissed when this exchange of data occurs. And once this data is entered incorrectly into the patient monitor, it can also be input incorrectly into the patient EHR.

"One of the things we emphasized in the report is that there's a new and important standard [focusing] on a risk management standard specifically for managing data across hospital networks," said Keller. "Hospitals haven't broadly adopted the standard, and we're encouraging hospitals that if they're moving toward interoperability with medical devices and EHRs, they consider the risks associated with doing that."

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)