jueves, 8 de junio de 2017

Implications of electronic health record downtime: an analysis of patient safety event reports. - PubMed - NCBI

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Backup Procedures Vital When Electronic Health Records Systems Go Down

An analysis of more than 80,000 patient safety event reports at a large mid-Atlantic health system found 76 were caused by electronic health record systems that had stopped working, according to a recent AHRQ-funded study in Journal of the American Medical Informatics Association. In nearly three-quarters of those instances, however, correct downtime procedures either were not followed or did not exist. The most common safety incidents, recorded over a three-year period ending in January 2016, involved patient misidentification, the miscommunication of clinical information when ordering labs tests or seeking lab results and ordering incorrect medications. Study authors concluded that all facilities should reduce patient risks by developing and practicing procedures for downtimes that may occur during regular maintenance or due to equipment failures, power outages or cyber attacks. Access the abstract.


Implications of electronic health record downtime: an analysis of patient safety event reports. - PubMed - NCBI



 2017 May 30. doi: 10.1093/jamia/ocx057. [Epub ahead of print]

Implications of electronic health record downtime: an analysis of patient safety event reports.

Abstract

OBJECTIVE:

We sought to understand the types of clinical processes, such as image and medication ordering, that are disrupted during electronic health record (EHR) downtime periods by analyzing the narratives of patient safety event report data.

MATERIALS AND METHODS:

From a database of 80 381 event reports, 76 reports were identified as explicitly describing a safety event associated with an EHR downtime period. These reports were analyzed and categorized based on a developed code book to identify the clinical processes that were impacted by downtime. We also examined whether downtime procedures were in place and followed.

RESULTS:

The reports were coded into categories related to their reported clinical process: Laboratory, Medication, Imaging, Registration, Patient Handoff, Documentation, History Viewing, Delay of Procedure, and General. A majority of reports (48.7%, n  = 37) were associated with lab orders and results, followed by medication ordering and administration (14.5%, n  = 11). Incidents commonly involved patient identification and communication of clinical information. A majority of reports (46%, n  = 35) indicated that downtime procedures either were not followed or were not in place. Only 27.6% of incidents ( n  = 21) indicated that downtime procedures were successfully executed.

DISCUSSION:

Patient safety report data offer a lens into EHR downtime-related safety hazards. Important areas of risk during EHR downtime periods were patient identification and communication of clinical information; these should be a focus of downtime procedure planning to reduce safety hazards.

CONCLUSION:

EHR downtime events pose patient safety hazards, and we highlight critical areas for downtime procedure improvement.

KEYWORDS:

downtime, EHR; electronic health records; patient safety

PMID:
 
28575417
 
DOI:
 
10.1093/jamia/ocx057

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