Advanced EHR Use Brings 27% Decline in Patient Safety Errors

By Jennifer Bresnick for HealthIT Analytics

A drastic reduction in patient safety errors can be attributed to the use of advanced EHR systems, a Pennsylvania study finds.

The implementation and use of advanced EHR systems in Pennsylvania hospitals has produced a 27% decline in negative patient safety events, states an October study by researchers from Carnegie Mellon University and the Pennsylvania Patient Safety Authority (PSA). The gains include a 30% reduction in medication errors and a 25% drop in adverse events due to complications, adding to the body of evidence that EHR use can improve quality and safety on a measurable scale.

Citing the critical Institute of Medicine “To Err is Human” study of 2000, which stated that up to 98,000 people die from preventable medical errors every year, the researchers hoped to examine whether EHRs are truly a viable solution for the intractable problem. “Health information technology is widely considered part of the solution to improving the safety of healthcare in the United States,” write Muhammad Zia Hydari and Rahul Telang of Carnegie Mellon and William M. Marella from the PSA. “The question of interest is whether hospitals’ adoption of health IT has matched expectations and improved patient safety.”

“Too many patient safety events occur in hospitals, and too many patients are placed at risk of harm unnecessarily,” the paper continues. “There is consensus among clinicians, healthcare managers, policy makers, and other stakeholders that this status quo is untenable. Technology may not be a panacea for healthcare’s myriad problems, but for patient safety events in Pennsylvania hospitals, we find that advanced EHRs have a substantial beneficial effect. Further efforts in fostering adoption and meaningful use of EHRs may make the benefits more universal and help in saving patients from the risk of harm in hospitals.”

Using data from the PSA’s vast database of state-mandated patient safety event reports, as well as information from HIMSS, the American Hospitals Association, and the Pennsylvania Health Care Cost Containment Council, the team constructed a panel of Pennsylvania hospitals with patient safety information from 2005 to 2012. The 231 unique hospitals reported a total of 1.7 million events over the eight year period, including 522 that resulted in permanent harm and 2,545 that ended in deaths.

The study focuses on three major categories where EHR technology may have a measurable impact: medication errors, adverse events due to complications, and errors related to procedures. The authors note the significant positive impact of tools such as computerized provider order entry (CPOE) on the number of medication errors. CPOE use eliminates the need for pharmacists to access paper patient charts directly, provides greater clarification for prescriptions that may impact the proper administration of the drug, and removes a number of possibilities for errors in manual transcription, misplaced paper orders sent by fax or courier, and miscommunications.

Even though only 67% of hospitals had adopted an advanced EHR system by the end of the study period in 2012, the reductions in errors represent significant gains aided by the use of health IT. As EHR adoption reaches nearly every hospital in the country, and meaningful use continues to push the technical capabilities of health IT, healthcare organizations will become increasingly well-equipped to reduce and prevent potentially fatal errors.

“As our study shows, improvement in patient safety is an additional benefit of advanced EHR adoption that non-adopting hospitals should take into account when evaluating IT investments,” the study concludes. “Policy makers, who expected improvement in patient safety due to EHRs, may find validation for their expectations. Although we do not separate out patient safety events, to focus on new events introduced by health IT or historically existing errors exacerbated by health IT, we find in aggregate counts that there is an overall improvement in patient safety from the adoption of advanced EHRs.”