Posted: March 3, 2014

As faithful readers of these columns may recall, Dr. Stark has been predicting that the electronic health record (EHR) in its current level of development is likely to make health care worse.  Now comes a study from CRICO the malpractice insurer for all Harvard-affiliated health-care professionals that confirms this suspicion.  CRICO examined a large number of malpractice claims arising within the Harvard Medical School community and found the following information.  Of 147 law suits, 20% arose from incorrect information being placed in the EHR.  An additional 16% were related to mistakes made when paper charts were converted to their EHR.  10% were attributed to the copy-and-paste mentality of the modern physician, who is driven by his manager to create a long progress note to justify billing at the highest code.   The EHR makes this very easy.   Another 15% were related to errors in the way the EHR was accessed or used by someone supposedly trained in its use.  Half of the 147 cases resulted in severe patient injury.  The actual paper appeared in Patient Safety and Quality Healthcare and can be viewed here

The authors of the paper warn of continued difficulty until the products are improved.  Dr. Stark comments, “If this is the state-of-the-art healthcare at Harvard imagine what is happening in the real world.  Everybody working in the Harvard system is at the top of their game, and still awful mistakes get made.  The government has forced the EHR affliction on it before it was ready for prime time.  Stay tuned for more trouble.  This situation is rife for litigation, and more importantly, injury.”

Update 2020: the latest issue to come to the forefront is the audit trail.  Dr. Stark discusses this in a 2020 post.  Click here to see the full text.  Briefly, the ability of attorneys to go into the EHR and see when changes were made is a huge problem for doctors who attempt to change a record after they have been notified of a lawsuit.