Electronic health record usability issues and potential contribution to patient harm.
Approach to Improving Safety
Setting of Care
As electronic health records (EHRs) have become ubiquitous, our understanding of their benefits and potential harms has evolved. In particular, issues with EHR usability (the ease of understanding, learning, and using the interface) impair physician workflow and may result in harm to patients. In this study, investigators analyzed voluntary error reports from the Pennsylvania Patient Safety Authority and a multihospital academic health system for evidence of safety issues related to EHR usability. Although limited by the nature of the voluntary reports, which contained sparse details precluding assessment of causal factors, investigators did identify and categorize cases in which problems with EHR usability may have directly resulted in patient harm. Many EHR contracts with health care organizations include "hold harmless" clauses limiting the EHR vendors' legal liability, meaning that patients may not be able to seek compensation if EHR issues directly lead to harm. A WebM&M commentary discussed a case of contrast nephropathy arising in part due to a confusing EHR user interface.