EHR usability weaknesses have clear patient safety implications

Patient Safety Monitor Insider

January 6, 2016

IT and patient safety advocates call for better testing and standardization

Electronic health records may represent the future of medicine, but as of now, the technology is still going through some serious growing pains.

One of the biggest obstacles facing EHRs is usability, which can directly impact patient safety and quality care. Recent studies have pinpointed ways in which EHR vendors have failed to meet usability requirements outlined by the federal government, while others have identified usability gaps that implicate patient care.

Recently, the National Institute of Standards and Technology (NIST) issued new guidance aimed specifically at improving EHR usability and eliminating patient harm by "proactively addressing and mitigating the root causes of use errors from EHR design and implementation elements."

In developing the guidelines, researchers collected data on EHR usability at "two large multihospital healthcare systems," drawing from an online survey, site observations, follow-up interviews with users, usability testing of five different EHRs, and expert reviews of those EHRs.

Using that data, the guidelines outline three critical risk areas:

  • Identification of information—Includes entering information in the wrong chart or record, which can lead to delayed care or medication errors
  • Consistency of information—A lack of standardization means clinicians are unable to find information pertaining to test results, diagnosis, or medications, which can lead to misdiagnosis or medication errors
  • Integrity of information—Insufficient user control within the EHR makes navigation and editing difficult, which leads to inaccurate or incomplete information

Although many clinicians and researchers have pointed to operational difficulties within EHR systems, the NIST guideline distills these concerns and human factors into a few clear risk areas.

Continue reading this article on the Patient Safety Monitor website. Subscribers have free access to this article in the January issue.