EHR Interface May Contribute to Medical Errors

This article in the  throw-away "journal" Family Practice News caught my eye.

The article reports on a presentation given by Melonie Nance.  In one of the case reports:

 .. a patient was discharged in acute renal failure 30 minutes after the renal failure had been noted and documented by the critical care fellow. The fellow had entered the diagnosis into the electronic record at the end of a lengthy note but had not communicated the information to the otolaryngology resident who discharged the patient. The error was discovered quickly and the patient was readmitted 2 hours later.

The primary problem in this case was that data entry was mistaken for thorough communication. Critical patient information was hidden from the discharging physician and the record contained excessive information.

Information overload is common and preventable .. and of course, data entry is NEVER a substitute for picking up the phone and calling someone.

Comments

[Hippocrates]

This seems to be more of an issue of inadequate training. If properly implemented, EMR could reduce the need to use the phone. More conditions discussed in the link:

"Can Doctors Learn to Love EMRs? YES, IF:"

[Jacob Reider]

Hippocrates - I disagree. "It's a training issue" is classic VendorSpeak. The software needs to guide good decisions and facilitate the user experience. Training users to tolerate and se beyond a bad software design is not the way to go. Much better to design the software right in the first place. We have a long way to go in that regard.