Electronic health record–related safety concerns: A cross‐sectional survey

Menon, Shailaja; Singh, Hardeep; Meyer, Ashley N. D.; Belmont, Elisabeth; Sittig, Dean F.

doi:10.1002/jhrm.21146

Cited by 26 publications

(24 citation statements)

References 19 publications

(27 reference statements)

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“…Patient comments in interviews also support this view. Some researchers, however, assume underreporting of safety or privacy concerns in the context of EHR use 74. Despite some patients truly experiencing challenges, they, in general, seem to value, benefit from and report predominantly positive experiences with health record transparency and the open sharing of notes 49…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers, however, assume underreporting of safety or privacy concerns in the context of EHR use. 74 Despite some patients truly experiencing challenges, they, in general, seem to value, benefit from and report predominantly positive experiences with health record transparency and the open sharing of notes. 49 50 The area of privacy and a possible relation to frequency of use, or burden of illness, needs further study.…”

Section: Discussionmentioning

confidence: 99%

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Engaging patients through open notes: an evaluation using mixed methods

et al. 2016

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Objectives(A) To gain insights into the experiences of patients invited to view their doctors’ visit notes, with a focus on those who review multiple notes; (B) to examine the relationships among fully transparent electronic medical records and quality of care, the patient-doctor relationship, patient engagement, self-care, self-management skills and clinical outcomes.DesignMixed methods qualitative study: analyses of survey data, including content analysis of free-text answers, and quantitative-descriptive measures combined with semistructured individual interviews, patient activation measures, and member checks.SettingGreater Boston, USA.ParticipantsPatients cared for by primary care physicians (PCPs) at the Beth Israel Deaconess Medical Center who had electronic access to their PCP visit notes. Among those submitting surveys, 576 free-text answers were identified and analysed (414 from female patients, 162 from male patients; 23–88 years). In addition, 13 patients (9 female, 4 male; 58–87 years) were interviewed.ResultsPatient experiences indicate improved understanding (of health information), better relationships (with doctors), better quality (adherence and compliance; keeping track) and improved self-care (patient-centredness, empowerment). Patients want more doctors to offer access to their notes, and some wish to contribute to their generation. Those patients with repeated experience reviewing notes express fewer concerns and more perceived benefits.ConclusionsAs the use of fully transparent medical records spreads, it is important to gain a deeper understanding of possible benefits or harms, and to characterise target populations that may require varying modes of delivery. Patient desires for expansion of this practice extend to specialty care and settings beyond the physician's office. Patients are also interested in becoming involved actively in the generation of their medical records. The OpenNotes movement may increase patient activation and engagement in important ways.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Engaging patients through open notes: an evaluation using mixed methods

et al. 2016

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“…Whereas this research is important, efforts are needed to clarify and operationalize the “EHR‐related” concept. Some studies rely on perceptions by researchers, physicians, or lawyers and risk managers to assess EHR‐related safety. Other studies analyze events reported by clinicians who mention the involvement of technology; these events are then coded by researchers into various categories or some taxonomy .…”

Section: Conceptualization Of Ehr‐related Medication Errorsmentioning

confidence: 99%

“…Instances of health IT‐associated harm have been reported.” (pS2) EHR safety is a major problem in health care . Fifty‐three percent of respondents to a recent survey of members of the American Health Lawyers Association and the American Society for Healthcare Risk Management report experiencing EHR‐related serious events in the past 5 years . A study of Finnish EHR users confirms this widespread concern for EHR safety .…”

Section: Introductionmentioning

confidence: 99%

EHR‐related medication errors in two ICUs

Carayon

Brown

et al. 2017

J of Healthc Risk Manag

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The objective of this study was to describe the frequency, potential harm, and nature of electronic health record (EHR)-related medication errors in intensive care units (ICUs). Using a secondary data analysis of a large database of medication safety events collected in a study on EHR technology in ICUs, we assessed the EHR relatedness of a total of 1622 potential preventable adverse drug events (ADEs) identified in a sample of 624 patients in 2 ICUs of a medical center. Thirty-four percent of the medication events were found to be EHR related. The EHR-related medication events had greater potential for more serious patient harm and occurred more frequently at the ordering stage as compared to non-EHR-related events. Examples of EHR-related events included orders with omitted information and duplicate orders. The list of EHR-related medication errors can be used by health care delivery organizations to monitor implementation and use of the technology and its impact on patient safety. Health information technology (IT) vendors can use the list to examine whether their technology can mitigate or reduce EHR-related medication errors.

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“…The current health information technology (HIT) systems, such as the electronic health record (EHR) and clinical decisions support systems (CDSS), have great potential to support clinicians and ultimately improve quality of care [3–5]. However, despite the wide adoption of HIT systems, frustration and errors exist due to the lack of user-centered design and cognitive support among other factors [4, 6]. …”

Section: Introductionmentioning

confidence: 99%

Supporting novice clinicians cognitive strategies: System design perspective

Islam

Mayer

Clutter

2016

2016 IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI)

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Infections occur among all clinical domains. The changing nature of microbes, viruses and infections poses a great threat to the overall well-being in medicine. Clinicians in the infectious disease (ID) domain deal with diagnostic as well as treatment uncertainty in their everyday practice. Our current health information technology (HIT) systems do not consider the level of clinician expertise into the system design process. Thus, information is presented to both novice and expert ID clinicians in identical ways. The purpose of this study was to identify the cognitive strategies novice ID clinicians use in managing complex cases to make better recommendations for system design. In the process, we interviewed 14 ID experts and asked them to give us a detailed description of how novice clinicians would have dealt with complex cases. From the interview transcripts, we identified four major themes that expert clinicians suggested about novices’ cognitive strategies including: A) dealing with uncertainty, B) lack of higher macrocognition, C) oversimplification of problems through heuristics and D) dealing with peer pressure. Current and future innovative decision support tools embedded in the electronic health record that can match these cognitive strategies may hold the key to cognitively supporting novice clinicians. The results of this study may open up avenues for future research and suggest design directions for better healthcare systems.

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Electronic health record–related safety concerns: A cross‐sectional survey

Cited by 26 publications

References 19 publications

Engaging patients through open notes: an evaluation using mixed methods

Engaging patients through open notes: an evaluation using mixed methods

EHR‐related medication errors in two ICUs

Supporting novice clinicians cognitive strategies: System design perspective

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