Electronic Health Records


Human intervention prevents Epic blunder

By Kyle Murphy, PhD

- Last week, a nurse for a Contra Costa correctional inmate prevented the facility’s electronic health record (EHR) from recommending a fatal dose of heart medication. As Mathias Gafni of the Contra Costa Times reported yesterday, the nurse’s knowledge of her patient’s history enabled her recognize the incorrect dosage of Digoxin and correct the electronic gaffe.

According to the report, this isn’t the first error caused by the Epic system, which went live on July 1 as a means of connecting the correctional facilities with the rest of the Contra Costa health system. Before the Contra Costa County Board of Supervisors yesterday, two nurses and their union representative detailed their experiences with the EHR system. The Epic system costing $45 million has led to more than a 140 complaints to the California Nurses Association in July alone. A labor representative from the organization claimed the vendor was approaching the county as an experiment, providing zero fixes to the EHR.

While the story raises a red flag about the potential flaws of this Epic deployment in particular, more generally it emphasizes the need for providers to sustain a certain level of vigilance no matter the system that’s in use. Although vendors advertise their software as solutions, they are by no means the final solution to all that ails the American healthcare industry.

Commonsense dictates that physicians and nurses ought to check that the system is correct in that same way that EHRs aid the former in clinical decision-making and medication administration. The relationship between providers and systems is reciprocal. Just as the development of anti-lock brake system doesn’t mean drivers should avoid pumping their brakes, so too doesn’t the use of an EHR system preclude healthcare professionals from exercising good judgment.

The first month of the Epic EHR doesn’t bode well for its ability to regain the trust of its users. Then again, how many of these negative experiences can be chocked up to human error, seeing as how only two training sessions were offered? Although a month’s worth of use doesn’t seem to be a large enough sample size, the fact that the EHR has already accounted for numerous errors and complaints warrants some serious reconsideration of what the return on a significant investment will actually turn out to be.

For more information, read the complete report.

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