There’s no evidence of a provider being sued (yet) for not using an EHR – but could it happen?
I often receive actual patient charts (with the PHI redacted) to do EHR demonstrations for prospective customers. It is not unusual for the EHR (Sevocity) to identify issues that I don’t see otherwise mentioned in the chart. Two examples:
High Blood Pressure:
While setting up a demonstration for a gastroenterologist I received a patient progress note where the nurse had documented a blood pressure of 120/99. The nurse did not document any hypertension drugs among the patient’s activate medications. The provider did not document anything in the progress note regarding the blood pressure and a diagnosis of hypertension was not added to the patient’s paper chart.
EHR: When entering this patient’s note into the EHR for the demonstration the nurse received a vital alert (pop-up and red) and when the provider opened the note they received the same alert. Would this alert have caused the provider to more easily recognize the patient’s hypertension and address it?
Drug – Condition:
I recently set up a demonstration for a patient with Diabetes Type II with impaired renal function (250.40). The patient was currently taking Fenofibrate among other medications.
EHR: When I entered the Fenofibrate into the EHR, I immediately received a Drug-Condition warning. Would this warning have caused the provider to select another drug not contraindicated for impaired renal function? Even if the provider still wanted to use the Fenofibrate would the warning have encouraged the provider to document the reason for continuing with the Fenofibrate (our EHR has a place to document reasons for overriding warnings)?
While studies on the overall impact of EHRs on patient safety are mixed, these examples clearly illustrate that use of an EHR might prevent errors and/or oversight in some situations.
- In the above examples would use of an EHR been more effective than paper at enabling the provider to address dangerous conditions and take appropriate action?
- Now that the government is funding EHR adoption, would the patients in the above examples be able to use the provider’s lack of an EHR as an additional claim in litigation?
C Huddle – VP, Market Development