Critics say EMR dangers aren’t getting enough attention

by Anne Zieger on September 17, 2010

Are EMRs dangerous?

Are EMRs dangerous?

This week, a tragedy unfolded at Baltimore’s Johns Hopkins University, where a man distraught over his mother’s condition shot her, her doctor, and himself. This awful series of events — which ended in the death of the man and his mother– deserve plenty of attention, as the hospital industry is only just beginning to pay attention to the level of violence within its walls.

Still, as appalling as the level of hospital violence is (and it’s astonishing how often nurses, in particular, are assaulted), there may be another threat looming which could conceivably impose an even greater toll, including substantial losses of life. That threat, some say, is the massive electronic medical record rollout going on across the U.S. — specifically the errors generated by a nation of clinicians and employees struggling with new technology.

Maybe this is just naysaying and fearmongering by folks who fear change, as many other critics suggest. But before you laugh the idea of EMR dangers off, you may want to think through a few of the following points.

Let’s stop for a minute and say that without a doubt, installing EMRs is going to change hospital workflow, as well as processes in medical practice. And common sense dictates that when you change how you execute a risky dance like healthcare. But still…

Research is increasingly suggesting that these systems are spawning serious errors. According to research by The Huffington Post Investigative Fund,electronic medical record rollouts could actually be dangerous to patients. The HuffPo has documented numerous instances in which mistakes with EMRs — typically, by clinicians or staff members newly training on the technology  — led to errors that could have harmed patients.

Yes, HuffPo is a liberal publication, which might in some way have influenced its take (though I don’t know that digitizing anything one way or the other is a party line thing).  But that publication isn’t alone.

For a taste of the medical resistance to EMRs, dig in to this scathing piece by IT analyst and physician Scot M Silverstein MD.  In a piece for blog Health Care Renewal, he makes several points worth chewing over.

One critical point he makes — which squares with everything your editor has seen in the business — is that physicians are actually early technology adopters. (After all, they were way ahead of the crowd as smartphones rolled out.)  Given this willingness to geek out, their  failure to love up EMRs should be a big concern.

Another key argument he makes, rightfully, is that most IT departments have never taken on a project which required them to have the kind of incredible sensitivity they need to *really* make  user interfaces work right. Not one to mince words, he says most software engineers are “willfully ignorant, complacent and negligent” when it comes to thinking about user needs.

So, given just these data points, isn’t it time we look at our headlong rush into EMR spending and see if these systems can be tamed?  What do you think?  I await your flames. :-)

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{ 4 comments… read them below or add one }

S Silverstein September 21, 2010 at 2:35 am

I actually wrote that the health IT industry is

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Anne Zieger September 21, 2010 at 11:48 am

Thank you for the clarification, Dr. Silverstein. It sounds as though you’re skeptical that *any* player in the health IT world is likely to produce a safe EMR, including vendors. If so, it seems to me that we could be headed for a disaster.

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Jim Williams, MD September 21, 2010 at 11:42 am

Timely report. The dangers of HIT are widespread. The vendors have been able to avoid the usual standards for selling medical devices for use in medical care. Are these any better than snake oil? Where is the FDA?

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Anne Zieger September 21, 2010 at 11:50 am

Dr. Williams, I share your concern about the lack of regulation of EMRs. To be honest, I think it’s a bit of a stretch to classify them as “medical devices,” but given their critical importance to patient health it may indeed be time to get the FDA involved. If I hear anything about their getting involved I’ll report it here.

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