Electronic Health Records and Medication Errors
Abstract
With the rapidly evolving face of healthcare, the implementation of electronic health records (EHRs) with digital physician order entry has grown in popularity. Medication error is a problem has been an ongoing challenge in healthcare systems globally. Medication errors occur for numerous reasons, some of which are poor prescribing, illegible handwriting and improper documentation. Electronic health records aim to combat this challenge by providing solution to some of these causative factors. The purpose of this proposal is to provide a background review to ascertain the effect of EHR implementation on the rate of medication error in a psychiatric institution. The paper covers the epidemiology, complications, diagnosis, presentation and complications for electronic health records as it relates to medication errors.
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Electronic Health Records and Medication Errors
Electronic health records (EHRs) have rapidly revamped the face of healthcare. EHR is a computerized way of storing and retrieving patient’s information. As digital transformation has changed other spheres of science, the delivery of healthcare has equally been touched in a bid to find solutions to problems faced by health professionals (Khalifa, 2017). Clinical information systems that have been developed include electronic medical records, electronic prescription ordering systems and automated drug dispensing systems. The electronic health records have proven that they have the potential to improve the efficiency and effectiveness of healthcare providers, thereby imparting some confidence in medical systems that have adopted information technology including psychiatric hospitals (Khalifa, 2017). Electronic Health Records and Medication Errors
One problem plaguing health systems today is medication errors. Since the institute of medicine (IOM) published the report to err is to human, much focus has been placed on improving safety. Medication error reduction is among the remediation measures published in the report (Gaffney, Hatcher, Milligan & Trickey, 2019). Electronic health records not only store patient’s information, but they come equipped with support features such as: alerting providers of patient allergies, drug to drug interactions, identify potential conflicts when a new medication is prescribed and have an e-prescribing feature to solve the issue of handwriting illegibility or order confusion. These features aid in the reduction of medication errors (Wani & Malhotra, 2018) Electronic Health Records and Medication Errors. The proposals seek to ascertain the role electronic health records play in the reduction of medication errors in a psychiatric institution.
Electronic Health Records are technology-based computer programs that contain patients’ personal medical history, test results, dictations, and other medical and related financial information (Wani and Malhotra, 2018). Electronic health records guarantee the integration and make available patients data and improve efficiency and cost reduction hence making health practitioners’ work easier (Dubovitskaya, Xu, Ryu, Schumacher & Wang, 2017). The records can be shared within a hospital facility, regionally or nationwide by a connection of computers linked by a network. On so doing sharing of patients’ data is made easy, especially in cases of referrals and tracing patients’ backgrounds and even in the electronic collation of patients’ data (Campanella et al., 2016 Electronic Health Records and Medication Errors.
The FDA defines medication errors as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer” (Food and Drug Administration, 2019, p.1).
Medication errors and related adverse events are frequently responsible for patient harm. In the United States, there are seven to nine thousand people who die yearly as a result of medication error (Tariq & Scherbak, 2019). There are many other cases involving medication errors that remain unreported. The complications that arise with medication errors exceeds forty billion yearly (Tariq & Scherbak, 2019). The Food and Drug Administration reports over 100,000 yearly cases of medication errors and associated cases (Food and Drug Administration, 2019).
The prevalence of basic electronic health records adoption since 2015 is sixty-five percent of all hospitals in the United States. The basic adoption rate in general medical hospitals were eight in ten, however only 15% of psychiatric hospitals adopted electronic health records (HealthIT, 2016). These statistics begs the inquiry of whether electronic health records adoption would reduce the rate of medication errors in psychiatric institutions.
Clinical Presentation & Complications
Medication errors have been proven to cause complications such as death, life threatening scenarios, disability, birth defects and hospitalization (Food and Drug Administration, 2019) Electronic Health Records and Medication Errors.
Electronic medical records allow for quick decision making, thereby improving the productivity of nurses and doctors (Campanella et al., 2016). Better information for decision making arises from traceable records kept in computers; therefore, medics do not have to ravage through volumes of paperwork. Computerized medical records allow for service customization, where a health facility can design its software that works to its convenience (Azaria, Ekblaw, Vieira & Lippman, 2016). Improper use of an electronic health records system may threaten the integrity of patient’s information that may result in patient harm or even death (Khalifa, 2017). Also, the cost of installation and maintenance of the system would push costs upwards for the sponsors of psychiatric patients thereby making healthcare expensive (Dubovitskaya, Xu, Ryu, Schumacher & Wang, 2017).
Medication errors are mostly diagnosed when an incident report form is filled and the data is logged in the institution’s database. Other ways of identifying medication errors include: noticing deterioration in a patient’s condition following medication administration, duplication of medication, missing medication, or misinterpretation or miscommunication between nurse and physician (Tariq & Scherbak, 2019) Electronic Health Records and Medication Errors.
Conclusion with PICOT
For patients admitted in psychiatric institutions, the implementation of electronic health records facilitates faster delivery of healthcare compared to paper charting since the model would decrease medication errors within six months of its implementation, thereby increasing the efficiency. Thus, the advantages of the adoption of electronic medical records outweigh its demerits and therefore acts as a positive step towards the advancement of healthcare. The structured PICOT question reads: In patients admitted to a psychiatric institution that converted from paper charting to electronic health records (P), does the implementation of electronic health records (I) compared to paper charting (C) decrease medication errors (O) within 6 months of its implementation (T).
References
Azaria, A., Ekblaw, A., Vieira, T., & Lippman, A. (2016, August). Medrec: Using blockchain for medical data access and permission management. In 2016 2nd International Conference on Open and Big Data (OBD) (pp. 25-30). IEEE.
Campanella, P., Lovato, E., Marone, C., Fallacara, L., Mancuso, A., Ricciardi, W., & Specchia, M. L. (2016). The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. The European Journal of Public Health, 26(1), 60-64.
Dubovitskaya, A., Xu, Z., Ryu, S., Schumacher, M., & Wang, F. (2017). Secure and trustable electronic medical records sharing using blockchain. In AMIA annual symposium proceedings (Vol. 2017, p. 650). American Medical Informatics Association.
Food and Drug Administration, . (2019, August 23). Working to reduce medication errors. In FDA. Retrieved from https://www.fda.gov/drugs/drug-information-consumers/working-reduce-medication-errors
Gaffney, T., Hatcher, B., Milligan, R., & Trickey, A. (2019, August 23). Enhancing Patient Safety: Factors Influencing Medical Error Recovery Among Medical-Surgical Nurses. The Online Journal of Nursing Issues, 21(3), 1-8. doi:10.3912/OJIN.Vol21No03Man06 Electronic Health Records and Medication Errors
HealthIT, . (2016, May). Adoption of Electronic Health Record Systems among U.S. Non-Federal Acute Care Hospitals: 2008-2015. In The Office of the National Coordination of Health Information Technology. Retrieved from https://dashboard.healthit.gov/evaluations/data-briefs/non-federal-acute-care-hospital-ehr-adoption-2008-2015.php
Khalifa, M. (2017, August). Perceived Benefits of Implementing and Using Hospital Information Systems and Electronic Medical Records. In ICIMTH (pp. 165-168).
Tariq, R., & Scherbak, Y. (2019, April 28). Medication Errors. In NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519065/
Wani, D., & Malhotra, M. (2018). Does the meaningful use of electronic health records improve patient outcomes?. Journal of Operations Management, 60, 1-18. Electronic Health Records and Medication Errors