Electronic health records are becoming an increasing factor in medical malpractice claims, according to a recent analysis conducted by The Doctors Company, the largest physician-owned medical malpractice insurer.
Although electronic health records (EHRs) issues were only involved in 1% of a sample of lawsuits from 2007 to 2013, the frequency of EHR-related lawsuits doubled between 2013 and 2014. Because legal cases take so long to resolve, there may be a lag in seeing the effect of EHRs on lawsuits; but, in all likelihood, it appears that issues regarding EHRs will only grow in the future, according to the analysis.
The Doctors Company identified two types of EHR problems: system factors — including technology, design and security issues, and user factors — which include errors attributable to users. In its analysis of closed claims, The Doctors Company attributed user factors as contributing to 64% of EHR-related claims, and system factors as contributing to 42% of claims.
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Examples of system factors with EHRs include: failure of system design, technology failure, lack of EHR alert/alarm/decision support, insufficient area for documentation, incompatible systems, and failure to ensure EHR security. User factors include: incorrect information in the EHR, hybrid health records, pre-populating/copy and paste errors, and lack of training/education.
Typical errors included faulty voice-recognition software, lack of drug alerts, wrong clicks on drop-down menus, typos that lead to medical errors, and very often, simply the user’s lack of training on the system.
Most — 42% — of EHR claim events happened in a hospital clinic or doctor’s office, while less claims happened in ambulatory surgery (12%), patients’ rooms (10%), and operating rooms (9%). Twenty percent of the claims were related to internal medicine specialties, 16% were related to primary care or family medicine, and 15% were related to obstetrics/gynecology. The greatest percentage of EHR claims — 27% — were diagnosis-related (failure tao diagnose, wrong diagnosis, or delay in diagnosis), followed by medication related (19%).
References
- Allen A. 2015 May 4. “Electronic record errors growing issue in lawsuits.” POLITICO. Retrieved from: http://www.politico.com/story/2015/05/electronic-record-errors-growing-issue-in-lawsuits-117591.html.
- Troxel DB. Analysis of EHR Contributing Factors in Medical Professional Liability Claims. The Doctors Company. Retrieved from: http://www.thedoctors.com/KnowledgeCenter/Publications/TheDoctorsAdvocate/CON_ID_006908.