Thursday, August 16, 2012

More On Getting a Handle On How Well Or Not EHRs Are Working. And The Australian Approach.

The following editorial appeared a few days ago - showing how the EHR defect issue continues to be top of mind.

Providers need recourse regarding EHR defects

August 8, 2012 | By Marla Durben Hirsch
It's always great to read about the successful implementation of an electronic health record system, like this story published last week in Inside Tucson Business. After all, transitioning to an EHR is expensive and time consuming. If you're going to adopt an EHR--and that is the direction the healthcare industry appears to be moving in--the process should be as smooth as possible.
It's equally disheartening, however, to read the opposite kind of story. Blogger Rich Just posted this week about his practice's struggles with its EHR system: a glitch causes notes to disappear, sometimes to another section of the chart, sometimes into oblivion. According to Just, the practice discovered that the glitch occurred when physicians started the note before entering the vital signs, so now they can avoid the glitch. Still, despite vendor support, it can't be removed. 
It's bad enough that EHRs have design flaws such as usability problems, or backfiring features that impede workflow and functionality. But software glitches that lose data, cause the system to go down regularly and create other havoc really are inexcusable. They're also apparently rather common.
A Google search of "EHR horror stories" came back with a whopping 51,800 results. Granted, not every horror involved "glitches", but that's still a huge number. And those are just the ones reported on the Internet.   
So what's a hospital or physician to do?
There are some precautions that providers can take to avoid buying a problematic EHR system, of course. For instance, they can check out the KLAS rankings on EHR products, conduct research online, confer with colleagues, ask a vendor for a satisfaction and money back guarantee, and the like.
None of those, though, can assure that an EHR will be glitch-free--or that a glitch won't develop, such as during an upgrade; and all EHRs will need to be upgraded to be able to meet the upcoming Stage 2 of Meaningful Use.
So why not resurrect two concepts that have been discussed for years but never implemented?
Read Marla’s suggestions here:
After seeing the US suggestions it is important to recognise that there is some activity on the same area in OZ.

Welcome to the website for the TechWatch Study

We are tracking computer problems that affect the safety of Australian general practice
The TechWatch Study is the world’s first study of critical incidents specifically involving information technology and patient safety in general practice. Information technology has many benefits for clinical medicine. But problems with computer use can introduce new errors that affect the safety and quality of clinical care and may risk patient harm.
General practitioners from across Australia have been invited to join the TechWatch Study and help identify and track safety and quality issues arising from the use of computers in general practice.
Information collected though the TechWatch Study will be used by researchers to gain a better understanding of how to improve the safety of using computers in clinical practice. Our findings will guide the safe design and use of information technology in general practice.
The site with contacts etc. is found here:
For background:
“The TechWatch Study is being jointly led by Farah Magrabi, Michael Kidd, Teng Liaw and Enrico Coiera from the University of New South Wales and Flinders University and is funded by National Health and Medical Research Council (NHMRC) Project Grant 630583.”
I would encourage all GP’s to get involved so we can get a good feel for the situation in Australia.