I have posted a number of blog notes about hospital errors attributable to EHRs and the fact that "gag clauses" in hospital EHR contracts are used to suppress the reporting of such errors (see: Physician & Nurse Involvement in EHR Design; Patient Safety and EHR Gag Clauses; Reducing EHR "Wrong Orders" by Limiting the Number of "Open Charts"; Gag Clauses in EHR Contracts Documented; Concerns Raised about Patient Safety). Ross Koppel, an adjunct professor of sociology at the University Pennsylvania, is one of the leading experts in the country about EHR errors. He authored a recent article discussing such errors (see: What Do We Know About Medical Errors Associated With Electronic Medical Records?). Below is an excerpt from it which barely scratches the surface of the article. I urge you to link to it for more information about this important topic.
....[W]e must understand that the nation’s almost three trillion dollar investment in healthcare IT by physicians, hospitals, LTCs, the government, ambulance services, visiting nurse organizations, labs, pharmacies, et cetera provides little insight into the harm associated with the technology’s use....Thus, while EHRs and other forms of healthcare IT offer myriad and wondrous advantages–and returning to paper is inconceivable–we should also admit to the patient safety dangers and clinical inefficiencies the technology also creates. Of course we expect the HIT trade associations to always (and only) emphasize the technology’s benefits, but it’s far less acceptable that US regulators, who encouraged and, indeed, penalized its non-use, have heretofore sought to refute or disparage those who sought to document EHRs’ unwanted consequences. One of the additional reasons we have lousy data of EHRs’ harms, is because acknowledging harms was counter to the government’s effort to encourage EHR sales and implementation....In 1997, the EHR manufacturers convinced the FDA that oversight of its products would inhibit innovation. The manufacturers were aided in this effort by HIT enthusiasts, and several medical societies....EHRs have enjoyed a regulatory-free zone for safety and usability since then.
According to Koppel, a powerful coalition has developed between federal politicians, hospital executives, EHR executives, and EHR trade associations that discourages oversight over the use of EHRs in hospitals by federal regulatory agencies such as the FDA. As a result, medical errors that can be attributed to EHR design and software bugs are investigated only by hospital personnel, sometimes in concert with the vendors of the systems. This approach discourages coordinated efforts across hospitals running the same EHRs to detect errors and take the appropriate corrective action. Moreover, hospital personnel are commonly contractually forbidden to publicly discuss errors that have occurred with colleagues in other facilities. All of these actions result in both unacknowledged harm to patents and an instability to improve both the practicality and safety of EHRs. In time, this problem may be addressed but a solution does not seem to be on the horizon at the present time.