Even a physician champion and health IT proponent acknowledges that certain oversights during the technology implementation process could have adverse effects on patients.
Wendy Whittington, MD, chief medical officer at Anthelio Healthcare Solutions, supports the adoption of health IT. She has 20 years of experience as a practicing physician and says IT is a critical component of improving what ails today’s American healthcare system – but it isn’t an instant cure. “We can’t assume IT will fix a bad clinical workflow or process. Unless you fix that first, you won’t win.”
A classic example is when doctors order tests for patients in a hospital, Whittington explains. Often, the test results don’t come back until the patient has already gone home. In the paper world, it was often cumbersome to get these results to the physician. “When hospitals say that putting in a new health IT system will fix that, that can be really dangerous. If the test result just goes onto a list in somebody’s e-mail inbox, then the process is still broken.”
“If you have the resources and the wherewithal to fix every process when you put in a system, it will work,” Whittington says. Providers would be advised to include ticklers and reminders in their IT systems.
Whittington makes it clear she supports health IT. “I’m purely pro going electronic.” But, she adds, “We need to do what we’re doing, and then some. The underlying point is: We need to be mindful.”Here are five ways Whittington says poor healthcare IT implementation could harm patients:
- Patient care delay. Decentralization of information makes physicians hunt all over the record for the information they need. For example, patient weight put in one part of the record may not duplicate to other places, requiring the physician to search for information needed for drug dosing. This just causes more searching, and more delay.
- Unnecessary tests and studies. Information may be in the wrong format, such as a radiology report instead of an image, a table instead of a graph. While EHRs prevent needless studies by making information more readily available to physicians, when a physician is presented with information in a format that’s not familiar, it can actually prompt further study.
- Contraindicated treatments. While a central source of truth for things such as drug allergies within an EHR is useful -- and while EHRs have the potential to decrease adverse drug events -- alarm fatigue is a very real danger. Some systems give clinicians so many notifications, they don’t listen to any of them and override warnings too rapidly.
- Treatment for wrong patients. Many EHRs make it easy for physicians to order treatments for the wrong patient. While there are lots of promising new technologies designed to combat this problem, it still exists and it’s dangerous. Back in the paper chart days, it was possible to write on a wrong chart, but today it’s even easier to make that mistake digitally.
- Lack of test result follow-ups. Physicians can be lulled into a sense of comfort that “the system” will catch potentially overlooked follow-up items, causing them to lose their vigilance with follow-up completely.