I Have Seen the Future, and It Has Glitches
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After a visit to Lenin's Russia in the early part of the 20th century, Lincoln Steffens famously quipped, "I have seen the future, and it works."
Transported 90 years into the future, Steffens could make the same statement in other contexts and about the performance of many modern technologies - except possibly electronic health records (EHR).
Electronic Health Records
EHRs take the information that was once contained in patients' paper medical records and digitize it. Once digitized, as the Centers for Medicare & Medicaid Services (CMS) notes, patients' "key administrative clinical data," like doctors' or nurses' notes, medications, medical history, laboratory test results, immunizations and other information, is made instantly available to medical professionals with access to the system.
The United States government so believes in EHRs that the 2009 Recovery Act (stimulus bill) allocated over $20 billion to incentivize hospitals, clinics and other medical providers to invest in and use EHR systems. The government hopes that all patient EHRs would be available to and accessible by any doctor (when the patient gives permission to access the record).
Proponents of EHRs claim there are many benefits to digitizing all medical information pertaining to patients, including preventing the loss of patients' records, lessening the chance that medication errors will be made, reducing incidents of medical errors, medical malpractice, preventing duplicate medical tests, and more.
But there may be a glitch or two ...
As more and more hospitals and clinics around the world begin to implement and use EHRs in their facilities and across their networks, reports of "glitches" are beginning to surface.
Generally, EHRs encompass more than just patients' electronic medical records (EMR) and include all information surrounding or pertaining to patients, including scheduling. In a few instances in England, scheduling errors resulting from computer issues have led to a number of inconveniences and potential safety issues.
In one instance, according to the Oxford Times, a glitch in a hospital's electronic booking system caused a failure to notify a patient of the cancellation of an appointment, only to have the patient arrive for the non-existent appointment. The error, which occurred right after implementing the new system, also caused an ambulance back up in the emergency department, as hospital staff had difficulties booking patients into the hospital for care.
The Oxford Times noted that a hospital spokesman was unsure how long it would take to ensure the system was running smoothly, but said it could take months.
Another issue associated with electronic systems is their reliance on software that can develop bugs or cause issues when upgraded.
In January 2011, a software "glitch" took down an entire Swedish hospital's EHR system. The EHR system noticed a problem with software that was being added-on and instantly shut itself off to prevent corruption. While the system was off hospital staff could view patients medical records, but could not add information to them, including critical medication information (instead, paper notes were taken and had to be entered by hand when the system was finally up and running).
According to the Swedish hospital's information officer, this was not the first time the hospital had experienced a system shutdown and was "99.9 percent" positive that other hospitals experienced these types of EHR system shutdowns.
These issues are not just affecting hospitals overseas. In Pennsylvania, a hospital's EHR system had to be shut down (for 12 hours) after staff noticed the system was not working like it should following a routine system upgrade.
Patient Information Errors
More problematic, software glitches may cause problems with the accuracy of patients' medical records or any notes contained therein. In early 2010, the Veterans Affairs Department experienced issues with the Department of Defense's electronic health records - intermittently, the system would include information from other patients or exclude information in patients' records.
When issues like this happen sporadically, health professionals cannot be 100 percent certain that a patient's EHR contains complete information or even that particular patient's medical information.
Even with all of the promise, the shift to EHRs has introduced an air of uncertainty into the medical profession and situations that could quite literally be life and death. As a doctor-blogger who tracks EHR issues notes, hospitals have stated that none of these glitches have compromised patient safety.
If you or a loved one has suffered an injury due to a "glitch" in an EHR or because of another negligent act of a medical professional, speak with an experienced attorney about your legal rights.