The EHR is not the sharp end of the stick, but…
Electronic Health Records (EHR) are not the first things that come to mind when thinking about technology-caused medical accidents and safety hazards. There is a common believe that EHR software is much less safety critical than software that controls medical devices that are “closer to the heart” of the patient, like infusion pumps, radiology devices, surgical robots, etc. After all, who has ever been hurt by a database?
If people get hurt, it usually happens at the “sharp end of the stick“, and that’s the place that gets the attention when it comes to safety controls. However, with today’s connectedness of “smart” medical devices and our move towards interoperable networks of medical data device systems, EHRs are increasingly becoming the “blunt end of the stick” with immense power to control the “sharp ends”.
Some of the patient safety risks of EHRs are highlighted by a recent guest column at HealthIT Outcomes by Andy Aroditis. The column highlights patient misidentification risks among other errors. So how can we avoid these hazards? The classical medical devices industry (as well as other safety-critical industries such as avionics) applies Hazard Analysis methods to identify safety risks and mitigations. Can these methods also be used for EHR software? In a recent publication (to appear at the 2020 AMIA Informatics Summit), we demonstrate that these methods can indeed be effective.