Doctors who start using electronic health records are less likely to get sued than their colleagues who stick with traditional paper records, according to new findings from Massachusetts. The technology is being introduced with the goal of decreasing errors and streamlining patient care. But some researchers have worried that in transitioning to electronic records doctors could make more mistakes using new and unfamiliar systems - such as writing notes and prescribing drugs in the wrong patient's record.
"Electronic health records and other health technology, while there's a general belief that they're helpful… there's also been concern that these same systems can predispose to unrecognized types of (errors) and unsafe events," said Dr. Steven Simon, from the VA Boston Healthcare System. He and his colleagues found, however, that using electronic health records (EHR) was tied to an 84 percent lower chance of getting sued. Their study was published Monday in the Archives of Internal Medicine. "If nothing else, these results should be reassuring to physicians and to practices that there's a very, very little chance that EHRs and EHR adoption would increase their chance of malpractice claims," Simon told Reuters Health.
One researcher not involved in the study cautioned, though, that doctors may have to wait to see the longer-term effects of electronic records on malpractice suits - including whether the technology allows more medical decisions to be scrutinized in court.
An EHR a day keeps the lawsuits at bay. Image Source
Simon estimated about one-third of practices are currently using electronic health records, which allow different doctors treating a single patient to access each other's notes and see what medications the patient has been prescribed.
More advanced systems also warn doctors if they're about to prescribe a drug that may interact with other medications a patient is taking.
For the new study, Simon and his colleagues surveyed 275 Massachusetts doctors in 2005 and 2007 about if and when they had adopted electronic health records and compared that to medical malpractice claims against those doctors starting in 1995. Thirty-three of the participating doctors had been sued. The researchers calculated 49 claims before electronic records were adopted, including 13 resulting in a payment, and two claims after, neither leading to a payment.
"Electronic health records in general tend to improve the quality of care by decreasing the number of mistakes, and to the extent to which mistakes drive malpractice claims, you should be seeing less claims," said Dr. Sandeep Mangalmurti, who has studied health technology and malpractice at the University of Chicago. Still, he said, there might be a period while the electronic records are being introduced that more mistakes could happen.
"There's no question there are kinds of errors that get introduced - and they're solvable," said Dr. Brian Strom, who has also studied electronic health records at the University of Pennsylvania Perelman School of Medicine in Philadelphia. "What we need to do is, we need an iterative process that develops the product, identifies the errors, fixes the errors and keeps testing," said Strom, who wasn't part of the research team.
Aside from the impact on medical errors, Mangalmurti said in the long run, lawyers may use data from electronic health records in court, which could also make doctors more vulnerable to malpractice suits.
"Suddenly there's a lot more information available for scrutiny," Mangalmurti, who also wasn't involved in the new study, told Reuters Health. "Everything a physician does is now theoretically accessible by everyone," he said - such as how long doctors spend looking at a patient's records, or when they add or make changes to notes. The new research "is beginning to show what we expected, which is that at least in the short term, in this limited context, EHRs may help physicians," Mangalmurti said. "I think the jury's still out about the long-term effects."
Researchers said worries over malpractice suits probably aren't delaying the implementation of electronic health records as much as the initial costs of using them and the extra burden for doctors and nurses learning the systems.
"I don't think there's so much of a concern about the unintended consequences and risks," Simon said. "It's more about change."