Healthcare providers are not well prepared for the "unintended consequences" of the shift to greater use of health information technology, researchers say.
Providers are not equipped to recognize, analyze, and learn from patient safety problems linked to the use of health information technology, according to speakers at a health services research conference in Boston last week.
Providers are familiar with patient safety issues from the Institute of Medicine's landmark 1999 report on medical error, said Hardeep Singh a safety researcher at Michael E. DeBakey VA Medical Center in Houston. But health information technologies are completely changing the way doctors practice, he said.
Providers were not prepared for the "unintended consequences" of the shift to greater use of HIT, he said.
Singh cited cases from unpublished research of an HIT-linked delayed diagnosis of a life-threatening problem and a fatal fentanyl overdose linked to errors in electronic medical records.
"This stuff is happening," he said at the annual Academy Health meeting on health services research. "People are experiencing these events, but we are really, really not understanding or learning from these events."
Some errors are related to technology glitches. For example, in one case in England, 900 patients were prescribed Viagra instead of the antidepressant Wellbutrin. The error was discovered when the women in the group tried to fill their prescriptions, Singh said.
Others are related to human error and workflow changes. Even the best EHR system can be unsafe because humans are going to make errors, he said. Another potential problem. "You can have a perfectly functioning lab system and perfecting functioning EHRs, but they just don't connect very well and that interaction can lead to failure."
Andrew Lyzenga of the National Quality Forum said a literature review found the documented evidence of HIT safety is limited, so it is hard to draw definitive conclusions.
Some studies suggest that HIT can improve medication safety; others found HIT systems have little effect on patient safety. Some studies failed to report the harms of adverse events; others were narrowly focused.
Two resources were cited at the session: "Safer Guides" from the Office of the National Coordinator and The Joint Commission's 2015 report on HIT safety.