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How EHR usability issues put pediatric patients at risk

Electronic health records are fraught with usability issues that have proven detrimental to clinical workflow. Moreover, these issues put many patients, especially pediatric patients, at risk for injuries arising from medication errors. Pennsylvania residents should know that ONC is currently drafting voluntary rules for the use of EHRs in pediatric care and that Pew Charitable Trusts, in the effort to inform policymaking, has issued a new report.

This report brings up 12 possible ways that usability issues can threaten the safety of pediatric patients. It is based on collaborations between Pew and two children's hospitals as well as a large mid-Atlantic healthcare system. At each facility, researchers uncovered thousands of cases of drug prescribing and administration errors. Below are some of those potential safety events.

The EHR data display can make some patient health information inaccessible. For example, a doctor may provide special instructions for drug administration that cannot be seen by the nurse because it was written in a field designed for use by the pharmacy. Poor information display can fail to show an upcoming administration date and not even prompt the user to open the order for this data. In other cases, the EHR may fail to alert doctors about a drug allergy. Erroneous EHR settings may discontinue drugs for patients whose lives depend on them.

There are various ways that EHRs can form the basis for a medical malpractice claim. Alert failures, insufficient space for documentation, a lack of integration and even a lack of security measures to maintain confidential reports may be attributable to negligence on the part of the medical center. Victims may want a lawyer to evaluate their case. If retained, the lawyer might hire third parties to conduct an investigation and then begin negotiations for a reasonable out-of-court settlement.

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