媒体联络:
朱莉·基弗
Director, 研究 Communications, University of Utah Health
电子邮件: 朱莉.Kiefer@hsc.犹他州.edu
New 研究 suggests that hospital electronic health records (EHRs) that are difficult to use are also less likely to catch medical errors that could harm patients.
As clinicians navigate EHR systems, 警报, 提醒, and clinical guidelines pop up to steer decision making. Yet a common complaint is that these notifications are distracting rather than helpful. These frustrations could signal that built-in safety mechanisms similarly suffer from suboptimal design, 这项新研究表明. 研究ers found that EHR systems rated as being difficult to operate did not perform well in safety tests.
“Poor usability of EHRs is the number one complaint of doctors, 护士, 药剂师, and most health care professionals,” 大卫·克拉森，m.s.D., the study’s corresponding author and a professor of internal medicine at University of Utah Health. “This correlates with poor performance in terms of safety.”
Classen likens the situation to the software problems that led to two deadly Boeing 737 MAX airplane crashes in 2018 and 2019. In both cases, pilots struggling to use the system foretold deeper safety issues.
“Our findings suggest that we need to improve EHR systems to make them both easier to use and safer,克拉森说. He collaborated on the study with senior author David Bates, M.D., at Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, and scientists at University of California San Diego Health; KLAS Enterprises, LLC; and University of California, 旧金山.
The 研究 appears in the September 11 issue of JAMA网络开放.
Experts estimate that as many as 400,000 people are injured each year from medical errors that occur in 医院. Medical professionals predicted that widespread use of EHRs would mitigate the problem. But 研究 published by Classen, Bates and colleagues in 2020 showed that EHRs failed to reliably detect medical errors that could harm patients, including dangerous drug interactions. Additional reports have indicated that poorly designed EHRs could be a contributing factor.
To investigate further, the 研究 team studied EHR systems in 112 U.S. 医院. They compared results from an EHR experience survey taken by 5,689 clinicians with outcomes from an EHR safety evaluation tool. The Leapfrog CPOE EHR safety test examines whether medication orders that could potentially harm a patient properly triggers alert systems.
The study found that user experience strongly correlated with EHR safety. When users rated EHRs poorly, they said the systems were difficult to operate, 难学, 慢, 或效率低下.
In cases where clinicians experienced those troubles, those EHR systems were less likely to flag drug-drug interactions, a patient’s allergies to drugs, 重复的订单, excessive dosing or other harmful medication errors.
One explanation behind the link is a lack of quality control, Classen explains. Individual 医院 modify EHR operability to meet their specific needs. Some of these changes may be at the expense of safety. 更重要的是, despite the fact that there are many EHR systems, currently there are no standards for usability and safety.
“Hospitals and health systems have spent more than $100 billion on EHRs over the last decade, and most believe that these systems are completely safe and usable but that is not necessarily the case,克拉森说. “Hospitals should annually perform a safety check on their system to assure it is safe.”
Improving EHR systems in the long term may need a different approach, Classen explains. Just as the Federal Aviation Administration, 航空公司的制造商, and airlines jointly monitor and improve airline software, a similar collaborative effort with EHR vendors, 医院 and clinicians may be what’s needed to optimize EHR software for user satisfaction, safety performance and to ultimately reduce medical errors.
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The 研究 originally published as “Inpatient Electronic Health Record (EHR) Usability and Hospital EHR Safety Performance” and was supported by a grant from the Gordon and Betty Moore Foundation.