The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

Sax, Ulrich; Lipprandt, Myriam; Röhrig, Rainer

doi:10.15265/iy-2016-038

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…Changes should include administrative attention, investment in cybersecurity, and optimal collaboration between IT and healthcare professionals. (2) Other key improvements include prioritization of processes and system applications, creation of an ‘IT emergency task force’, downtime planning for short- and long-term outages along with regular training scenarios. (2)(8) Of note, the cause of the IT failure remained unknown in a large number of incidents.…”

Section: Discussionmentioning

confidence: 99%

“…IT-related functions involve hospital and pre-hospital emergency medical services (EMS) communication systems, radiology systems including imaging devices, electronic health records (EHR), and even robot-assisted surgery. (1)(2) The digital healthcare revolution has greatly improved efficiency and has helped to improve and optimize patient care and hospital staff productivity. (3) Conversely, failure or malfunction of IT systems has serious and widespread effects on hospital care continuity, including acute care service delivery.…”

Section: Introductionmentioning

confidence: 99%

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Acute care disruptions due to information technology failures in the Netherlands from 2000 to 2020

Boven

Kusters

Klokman

et al. 2023

Preprint

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Background: Healthcare organizations are becoming increasingly dependent on Information technology (IT) for the provision of routine services. IT failures within hospital systems can impact acute patient care, including emergency department (ED) closure and the cancellation of operations. This study aims to gain insight into the impact of hospital IT failures in the Netherlands on acute care delivery and to provide recommendations for future preparedness. Methods: This is a systematic scoping review of major acute care disruptions in Dutch hospitals between 2000 and 2020. Incidence of etiology, duration, ED diversion, and closure of multiple locations was evaluated. IT failures were included when associated with the closure of hospital departments and/or evacuations. Results: Thirty-nine IT failures resulting in acute care disruption were identified. The majority occurred between 2010 and 2020 (n=37, 95%). Of the 39 events, 33 (85%) were primary IT failures and were mainly caused by computer network and/or hospital software failure. Secondary events predominantly resulted from power failure. Most events (n= 36, 92%) were resolved within minutes to hours. All events were associated with an ED closure, 27 (69%) with an operating room (OR) stop and two (5%) with external hospital evacuation of one or more patients. Furthermore, 17 incidents (44%) involved multiple hospital locations, and seven (41%) of these involved closure of multiple locations with an ED. Conclusion: The impact of IT failures on acute care disruptions in the Netherlands has considerably increased since 2010. This stresses the urge to improve IT security and business continuity in todays hospitals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute care disruptions due to information technology failures in the Netherlands from 2000 to 2020

Boven

Kusters

Klokman

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…These include the potential for recording erroneous data entry leading to patient safety hazards, system design flaws, improper system use, inappropriate document capture, erroneous application of copy and paste functions within the medical record, rigid application of prepopulated templates, and errors related to clinical decision support systems such as alert fatigue [ 33 ]. In recent years, others have pointed to potential problems with EHRs as a vector for increased risk to patient safety with respect to incorrect use [ 34 , 35 ], malfunctions [ 36 , 37 ], interoperability or system interaction [ 38 ], and health information technology blackouts or downtime [ 36 , 39 ]. On the basis of our findings, we can reasonably assume that many of these issues persist.…”

Section: Discussionmentioning

confidence: 99%

Association of Electronic Health Record Vendors With Hospital Financial and Quality Performance: Retrospective Data Analysis

Beauvais¹,

Kruse²,

Fulton³

et al. 2021

J Med Internet Res

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Background Electronic health records (EHRs) are a central feature of care delivery in acute care hospitals; however, the financial and quality outcomes associated with system performance remain unclear. Objective In this study, we aimed to evaluate the association between the top 3 EHR vendors and measures of hospital financial and quality performance. Methods This study evaluated 2667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considered their performance with regard to net income, Hospital Value–Based Purchasing Total Performance Score (TPS), and the unweighted subdomains of efficiency and cost reduction; clinical care; patient- and caregiver-centered experience; and patient safety. We hypothesized that there would be a difference among the 3 vendors for each measure. Results None of the EHR systems were associated with a statistically significant financial relationship in our study. Epic was positively associated with TPS outcomes (R2=23.6%; β=.0159, SE 0.0079; P=.04) and higher patient perceptions of quality (R2=29.3%; β=.0292, SE 0.0099; P=.003) but was negatively associated with patient safety quality scores (R2=24.3%; β=−.0221, SE 0.0102; P=.03). Cerner and Epic were positively associated with improved efficiency (R2=31.9%; Cerner: β=.0330, SE 0.0135, P=.01; Epic: β=.0465, SE 0.0133, P<.001). Finally, all 3 vendors were associated with positive performance in the clinical care domain (Epic: β=.0388, SE 0.0122, P=.002; Cerner: β=.0283, SE 0.0124, P=.02; Meditech: β=.0273, SE 0.0123, P=.03) but with low explanatory power (R2=4.2%). Conclusions The results of this study provide evidence of a difference in clinical outcome performance among the top 3 EHR vendors and may serve as supportive evidence for health care leaders to target future capital investments to improve health care delivery.

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“…A lack in usability could induce risks for health care that lower the provided level of care. Finally, one should not forget that software, hardware, or electrical power supply can fail or can be a target for criminal attacks [66]. An overall perspective on the value of EMRs must therefore include a broader definition of assets and drawbacks.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

Value of the Electronic Medical Record for Hospital Care: Update From the Literature

Uslu¹,

Stausberg²

2021

J Med Internet Res

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Background Electronic records could improve quality and efficiency of health care. National and international bodies propagate this belief worldwide. However, the evidence base concerning the effects and advantages of electronic records is questionable. The outcome of health care systems is influenced by many components, making assertions about specific types of interventions difficult. Moreover, electronic records itself constitute a complex intervention offering several functions with possibly positive as well as negative effects on the outcome of health care systems. Objective The aim of this review is to summarize empirical studies about the value of electronic medical records (EMRs) for hospital care published between 2010 and spring 2019. Methods The authors adopted their method from a series of literature reviews. The literature search was performed on MEDLINE with “Medical Record System, Computerized” as the essential keyword. The selection process comprised 2 phases looking for a consent of both authors. Starting with 1345 references, 23 were finally included in the review. The evaluation combined a scoring of the studies’ quality, a description of data sources in case of secondary data analyses, and a qualitative assessment of the publications’ conclusions concerning the medical record’s impact on quality and efficiency of health care. Results The majority of the studies stemmed from the United States (19/23, 83%). Mostly, the studies used publicly available data (“secondary data studies”; 17/23, 74%). A total of 18 studies analyzed the effect of an EMR on the quality of health care (78%), 16 the effect on the efficiency of health care (70%). The primary data studies achieved a mean score of 4.3 (SD 1.37; theoretical maximum 10); the secondary data studies a mean score of 7.1 (SD 1.26; theoretical maximum 9). From the primary data studies, 2 demonstrated a reduction of costs. There was not one study that failed to demonstrate a positive effect on the quality of health care. Overall, 9/16 respective studies showed a reduction of costs (56%); 14/18 studies showed an increase of health care quality (78%); the remaining 4 studies missed explicit information about the proposed positive effect. Conclusions This review revealed a clear evidence about the value of EMRs. In addition to an awesome majority of economic advantages, the review also showed improvements in quality of care by all respective studies. The use of secondary data studies has prevailed over primary data studies in the meantime. Future work could focus on specific aspects of electronic records to guide their implementation and operation.

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The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

Cited by 12 publications

References 21 publications

Acute care disruptions due to information technology failures in the Netherlands from 2000 to 2020

Acute care disruptions due to information technology failures in the Netherlands from 2000 to 2020

Association of Electronic Health Record Vendors With Hospital Financial and Quality Performance: Retrospective Data Analysis

Value of the Electronic Medical Record for Hospital Care: Update From the Literature

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