Copying Notes Into EHR Can Increase Patient Harm

Recently, the American Medical Informatics Association came out with a report that outlined how physicians and clinics can reduce EHR errors. Of course, there are always going to be errors in just about anything; we’re human beings, and they happen.

However, the amount of errors some doctors are reporting are a bit disturbing. A writer on the Fierce EMR blog spoke with one physician who said that every EHR has errors in it. Some of these are “copy and paste” errors that are messed up when they’re transferred from one EHR to the next. While copy and paste can be a useful, time-saving tool, it can also cause problems and put patient safety at risk.

How to Reduce EHR Errors

Fierce EMR spoke with a physician with the Medical College’s Department of Medicine, who listed some good ideas for reducing errors in EHR.

1. Don’t use the copy and paste function for patient notes without attribution.

2. Don’t repetitively copy and paste lab results and radiology reports.

3. Note important results with proper context, and document any resulting actions.

There are two other useful steps, which you can find in the original Fierce EMR post.

The AMIA Report-Aviation and EHR Lessons

The AMIA Report made a unique and useful correlation between the medical industry and the aviation industry. Here’s what they concluded:

The aircraft industry developed industry groups where topics are discussed and conventions sanctioned by a large number of airframe manufacturers and aviation software and hardware vendors. These cooperative efforts have occurred despite the intensely competitive nature of the aviation sector as competitors see value in working together in this arena.

And, a bit later on in the report….

No single measure alone accounts for this success, but the mixture of measurement, reporting, and regulatory incentives has resulted in an admirable level of safety and continuous improvement from which other industries—including healthcare IT—can learn. In the USA, the Federal Aviation Administration regulates aircraft airworthiness, issues aircraft safety alerts, operates the Aviation Safety Reporting System, and in many other ways regulates aviation. Some have suggested that a structure analogous to the Aviation Safety Reporting System should exist in healthcare.

I think this is sound advice that should be acted upon. The aviation industry has to make decisions that play a key role in passenger safety; they have established processes in place to check and recheck equipment safety and emergency backstops.

While our industry doesn’t really need assistance with patient care or new triage techniques, we do need to put safety decision-making checks in place to make sure EHRs are accurate, and patients are kept safe. And, we could learn a lot from the mistakes the aviation industry has already had to go through.

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