Sittig Dean F, Singh Hardeep
Co-Author of Improving Outcomes-A Practical Guide to Clinical Decision Support Implementation and Clinical Information Systems: Overcoming Adverse Consequences.
J Healthc Risk Manag. 2013;33(2):21-6. doi: 10.1002/jhrm.21123.
Although electronic health records (EHRs) have a significant potential to improve patient safety, EHR-related safety concerns have begun to emerge. Based on 369 responses to a survey sent to the memberships of the American Society for Healthcare Risk Management and the American Health Lawyers Association and supplemented by our previous work in EHR-related patient safety, we identified the following common EHR-related safety concerns: (1) incorrect patient identification; (2) extended EHR unavailability (either planned or unplanned); (3) failure to heed a computer-generated warning or alert; (4) system-to-system interface errors; (5) failure to identify, find, or use the most recent patient data; (6) misunderstandings about time; (7) incorrect item selected from a list of items; and (8) open or incomplete orders. In this article, we present a "red-flag"-based approach that can be used by risk managers to identify potential EHR safety concerns in their institutions. An organization that routinely conducts EHR-related surveillance activities, such as the ones proposed here, can significantly reduce risks associated with EHR implementation and use.
尽管电子健康记录（EHRs）在改善患者安全方面具有巨大潜力，但与EHR相关的安全问题已开始显现。基于对美国医疗风险管理协会和美国健康律师协会会员进行的一项调查的369份回复，并辅以我们之前在与EHR相关的患者安全方面的工作，我们确定了以下常见的与EHR相关的安全问题：（1）患者身份识别错误；（2）EHR长时间不可用（计划内或计划外）；（3）未理会计算机生成的警告或警报；（4）系统间接口错误；（5）未能识别、查找或使用最新的患者数据；（6）对时间的误解；（7）从项目列表中选择错误的项目；以及（8）未结清或不完整的医嘱。在本文中，我们提出了一种基于“红旗”的方法，风险管理者可利用该方法识别其机构中潜在的EHR安全问题。一个经常开展与EHR相关监测活动的组织，比如这里提出的活动，能够显著降低与EHR实施和使用相关的风险。
