A red-flag-based approach to risk management of EHR-related safety concerns


  • Dean F. Sittig PhD,

    1. Co-Author of Improving Outcomes—A Practical Guide to Clinical Decision Support Implementation and Clinical Information Systems: Overcoming Adverse Consequences
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  • Hardeep Singh MD, MPH

    1. Chief of the Health Policy, Quality and Informatics Program, Houston Veterans Affairs (VA) Health Services Research and Development Center of Excellence
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Although electronic health records (EHRs) have a significant potential to improve patient safety, EHR-related safety concerns have begun to emerge. Based on 369 responses to a survey sent to the memberships of the American Society for Healthcare Risk Management and the American Health Lawyers Association and supplemented by our previous work in EHR-related patient safety, we identified the following common EHR-related safety concerns: (1) incorrect patient identification; (2) extended EHR unavailability (either planned or unplanned); (3) failure to heed a computer-generated warning or alert; (4) system-to-system interface errors; (5) failure to identify, find, or use the most recent patient data; (6) misunderstandings about time; (7) incorrect item selected from a list of items; and (8) open or incomplete orders. In this article, we present a “red-flag”-based approach that can be used by risk managers to identify potential EHR safety concerns in their institutions. An organization that routinely conducts EHR-related surveillance activities, such as the ones proposed here, can significantly reduce risks associated with EHR implementation and use.