The impact of electronic health records on diagnosis

Abstract

Diagnostic error may be the largest unaddressed patient safety concern in the United States, responsible for an estimated 40,000-80,000 deaths annually. With the electronic health record (EHR) now in near universal use, the goal of this narrative review is to synthesize evidence and opinion regarding the impact of the EHR and health care information technology (health IT) on the diagnostic process and its outcomes. We consider the many ways in which the EHR and health IT facilitate diagnosis and improve the diagnostic process, and conversely the major ways in which it is problematic, including the unintended consequences that contribute to diagnostic error and sometimes patient deaths. We conclude with a summary of suggestions for improving the safety and safe use of these resources for diagnosis in the future.

Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework

“…Echoing Nguyen et al’s evaluation [ 68 ], there was also a perception that patient safety and care quality could benefit from EMR introduction, by supporting the audit-and-feedback process, alongside improved medication management. However other reviews have found less conclusive evidence for this point [ 66 , 70 ].…”

Safeuristics! Do Heuristic Evaluation Violation Severity Ratings Correlate with Patient Safety Severity Ratings for a Native Electronic Health Record Mobile Application?

“…18 While some literature suggests that EHRs have improved both quality and safety of health care, 20,21 significant safety risks in patient care continue to be associated with the use of EHRs. 22,23 These risks include morbidity and mortality, 24 diagnostic errors, 25 disruptions in clinical workflow, and negative effects on patient-provider interactions. 26 These safety issues have led to a call to be more proactive in preventing errors through better EHR design.…”

Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process

“…Today, diagnosticians must filter, integrate, and interpret information from diverse sources. Some studies suggest the EHR may facilitate this process through better information sharing and timely access to data [5,6,7,8]. However, studies also raise concerns ranging from fragmentation of data, information siloes, and data overload [9,10,11,5].…”

“…Some studies suggest the EHR may facilitate this process through better information sharing and timely access to data [5,6,7,8]. However, studies also raise concerns ranging from fragmentation of data, information siloes, and data overload [9,10,11,5]. For example, some studies have shown that EHRs influence physician workflow, workload, and communication practices [12]; while others suggest that more computer time, means less patient time [13] leading physicians to be perceived as less effective communicators [14].…”