Hospitals Still Face the Rising Problem of EHR-related Malpractice

Hospitals Still Face the Rising Problem of EHR-related Malpractice To ensure accuracy in medical reports and excellent clinical practices, hospitals could consider investing in a reliable medical transcription company.

The main objective of every healthcare organization is to provide quality medical care to their patients and to do so, it is important to have clear patient records that allow physicians to provide optimal care. Accurate medical documentation reflects the efficiency of physicians and the quality of patient care provided in the hospital. Keeping a record of all relevant patient data helps physicians monitor the treatment given to the patient and reduce the chances of risk. A minor error in the medical report can affect the health of the patient as well as lead to malpractice lawsuits that come with penalties ranging from thousands to billions of dollars. So, to avoid medical errors healthcare organizations must have rules and regulations and should be HIPAA-compliant. To ensure accuracy in medical reports and to promote excellent clinical practices, hospitals could consider investing in a reliable medical transcription company.

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Today, almost all healthcare organizations are using EHR systems to draft medical records.

According to a new report from The Doctors Company, a leading malpractice insurer, malpractice claims in which the use of electronic health records (EHRs) has contributed to patient injuries have been growing for the past 8 years. The number of such claims paid by The Doctors Company rose from seven in 2010 to an average of 22.5 in 2017 and 2018, the report shows. Altogether, 216 EHR-related malpractice claims were closed during the 8-year period. In 2018, they represented just 1.39% of the claims, up from 1.02 percent in 2017 and 0.35 percent in 2010, the report states. Although the rate of malpractice in the medical industry is decreasing, it still continues to occur.

According to Dean Sittig, PhD, a professor at the University of Texas Health Sciences Center at Houston, the EHR malpractice persists in the healthcare industry because doctors using EHRs have jumped from 15 percent to more than 90 percent. As the use of EHRs spread from early enthusiasts to doctors who were just trying to get their work done, he added, typical EHR users no longer paid as much attention to their interaction with the computer software.

That relative inattention is what leads to errors.

Systems Error According to reports, the EHR components of the claims closed from 2010 to 2018 were due to either user-related issues or system technology and design issues like EHR failures (12%), lack of or failure of an EHR alert or alarm (7%), a fragmented record (6%), failure or lack of electronic routing of data (5%), insufficient scope/area for documentation in the EHR (4%), and lack of integration/incompatible systems (2%).

To show how a system failure can lead to malpractice, the report analyzed a case where an older patient consulted an otolaryngologist for sinus complaints. The physicians intended to prescribe "Flonase nasal spray" whereas the EHR misinterpreted it as "Flomax," a medication for enlarged prostates in men. The side effect of Flomax is that it causes hypotension and the patient went into the emergency department due to dizziness. To avoid such issues, experts say that the only time a computer should auto complete is when there is nothing else that could be a possible match. Also, physicians should use the proper abbreviations that the system can recognize.

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User-related Error According to the report, user-related malpractices include entering incorrect information (13%), pre populating/copy and paste (13%), hybrid health records/EHR conversion issues (13%), other user errors (12%), insufficient training and/or education (7%), alert issues/fatigue (2%), and computer order entry workarounds (2%). Copy and paste is a serious issue because when a doctor copies a previous note into the current note, then he or she doesn't always document changes in the patient's condition.

For example, the Doctors

Company said, a 38-year-old obese patient was presented for medical clearance and had normal test results. Three months later, the patient had shortness of breath and dizziness and his blood pressure was 112/90 and his pulse was 106, but no tests were ordered.After five days the patient died from pulmonary embolism. After the investigation, it was found that the progress note was identical to the previous note from 3 months earlier, including old vital signs and spelling errors. Clearly, it had been cut-and-pasted into the record. Just like cut and paste, there are other dangers too like when doctors click hundreds of times a day on dropdown menus, they're likely to make some errors. These mistakes can be replicated across the organization's system.

Researchers have shown that primary care doctors such as family physicians and internists are more likely to be sued when EHRs are one of the causes of patient injuries. This is because they see more patients than any other specialists and so they tend to use the EHR more. EHR-related issues for primary care doctors could be related to cut-and-paste, dropdown lists, and pre-population of EHR data. Patient injuries cited in these cases include death (25%), adverse reaction to medication (23%), need for surgery (15%), emotional trauma (14%), undiagnosed malignancy (13%), and organ damage (11%).

To make EHR documentation more effective, healthcare organizations can consider partnering with a reliable transcription company that offers EHR-integrated medical transcription services and HL7 interface to share the clinical records with the physicians.

Hospitals now prefer a combination of EHR and medical transcription to save physicians’ time and to ensure accurate and reliable patient records.

www.medicaltranscriptionservicecompany.com

918-221-7809