Overall, electronic health records are expected to reduce medical errors, but Dean Sittig has devoted a lot of research to the ways that EHRs themselves can fail, and how to avert those failures by conducting internal audits of clinical information systems and paying attention to red flags, the way physicians do when they examine a patient.
"A finding of 'swollen lymph nodes' during a routine physical examination should be investigated to rule out potentially serious systemic infections," says Sittig, associate professor in the School of Biomedical Informatics at the University of Texas Health Science Center at Houston. "Likewise, there are similar signs and symptoms related to potentially dangerous situations involving implementation and use of EHRs."
Just a few of Sittig's "red flags":
•The person in charge of making sure the EHR is appropriately backed up says that the backup tapes have never been tested.
•The organization is not up to date with the latest software patches from either the EHR vendor or the operating system
•Order sets have not been reviewed within the last two years
•One or more screens in the EHR don't include the patient's identifying data
•There is no computer-based method of notifying nurses that a new order has been entered
•There is no role-based system of access, and all users can see all patient data and use all applications
Sittig will present a blueprint for an EHR inspection program so that attendees can identify the red flags in their own operations: he'll cover where to look for potential problems, and which people should be asked what questions. His presentation, "Inspecting EHRs to Insure Safe Use: What is Required?" takes place Tuersday, Feb. 22, at 8:30-9:30 a.m.
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