User-unfriendly EHRs pose serious risks to patient safety

User-unfriendly EHRs pose serious risks to patient safety

Electronic health records that deliver suboptimal user experience are more likely to lead to alert fatigue and less likely to catch errors that could impact hospital safety, University of Utah Health research shows.

"Hospitals and health systems have spent more than $100 billion on EHRs over the last decade, and most believe that these systems are completely safe and usable but that is not necessarily the case," said Dr. David Classen, a professor of internal medicine at University of Utah Health

Because of this inherent risk in poorly designed electronic health records, all hospitals should "annually perform a safety check on their system to assure it is safe," said Classen, whose EHR research is published in the most recent issue of JAMA Network Open.

Classen worked on the research project with renowned patient safety innovation leader Dr. David Bates, from Brigham and Women's Hospital, as well as scientists at University of California San Diego Health. Researchers at UC San Francisco and KLAS Enterprises also contributed.

He's not one to undersell the scope of the problem – he said the situation is not unlike software glitches that led to two Boeing 737 MAX airplane crashes in 2018 and 2019, with pilots' struggles to make the software work showing more fundamental safety issues.

EHRs' built-in safety mechanisms need to be redesigned, the study suggests.

Classen argues that, just as the Federal Aviation Administration, airline manufacturers and airlines now jointly monitor and improve airline software, something similar needs to happen with EHR vendors, hospitals and clinicians – who should collaborate to optimize EHR software for usability, provider experience and patient safety.

In inpatient settings, EHR alerts, reminders and clinical guidelines pop up to steer clinicians' decision-making, the research notes. But it's long been a known that these notifications are very often more distracting than useful.

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