A recently conducted analysis undertaken by The Doctors Company, the largest medical malpractice insurance company owned by physicians, reported: “This type of EHR-related medical malpractice suit is becoming more common. For eight years, claims in which the use of EHRs contributed to patient injury have been on the rise.”
The Doctors Company found that claims in which EHRs contributed to injury were involved in 216 medical malpractice claims closed from 2010 to 2018: there were seven cases in 2010, which increased to an average of 22.5 cases per year in 2017 and 2018. However, medical malpractice cases in which EHR were a factor was only 1.1% of all claims closed since 2010.
The analysis found that EHRs are typically not the primary cause of medical malpractice claims but instead are contributing factors. Nonetheless, The Doctors Company warned that as EHR are nearly universally adopted, EHR “may become a more prevalent source of risk.”
The Doctors Company’s analysis found that EHR-related medical malpractice claims that were closed from 2010 to 2018 were caused by either system technology and design issues or by user-related issues. For user-related issues, incorrect information was involved in 29 cases (13%); pre-populating/copy and paste was involved in 29 cases (13%); hybrid health records/EHR conversion issues were involved in 27 cases (13%); user error (other) was involved in 25 cases (12%); training and/or education were involved in 16 cases (7%); alert issues/fatigue, user-related were involved in 5 cases (2%); and, computer order entry workarounds were involved in 4 cases (2%). For system technology and design issues, electronic systems/technology failure (EHR) was involved in 26 cases (12%); lack of or failure of EHR alert or alarm was involved in 15 cases (7%); fragmented record was involved in 14 cases (6%); failure/lack of electronic routing of data was involved in 10 cases (5%); insufficient scope/area for documentation in EHR was involved in 8 cases (4%); lack of integration/incompatible systems was involved in 5 cases (2%); failure to ensure information security was involved in 1 case (0%); and “other” was involved in 30 cases (14%).
The Doctors Company found the medical specialities with the highest percentage of medical malpractice claims where EHR are a factor were family medicine (8%); internal medicine (8%); cardiology (6%); and, radiology (6%). The most prevalent injuries alleged in EHR-related medical malpractice claims were death (30%); adverse reaction to medication (23%); need for surgery (15%); emotional trauma (14%); and, undiagnosed malignancy (13%).
Diagnosis-related allegations represented 31% of the total EHR-related medical malpractice claims.
In order to reduce the risks of EHR-related medical malpractice claims, The Doctors Company suggests that medical practitioners: avoid copying and pasting except when describing the patient’s past medical history; contact the organization’s IT department or its vendor if the practitioner notices that the auto population feature causes erroneous data to be recorded (if the auto populated information is incorrect, note it and document the correct information); review your entry after you make a choice from a drop-down menu; review all available data and information prior to treating a patient; and, relocate the computer so the physician’s back is not to the patient and so the patient can view the screen (remind the patient that you are listening carefully, even though you may be typing during the appointment and summarize or read the note to demonstrate you have listened).
If you or a loved one suffered serious injuries (or worse) due to possible medical malpractice involving electronic health records (EHRs) in the United States, you should promptly seek the advice of a medical malpractice attorney in your state who may investigate your medical malpractice claim for you and file a medical malpractice case on your behalf, if appropriate.
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