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Rush to electronic health records could cause more liability risk

Electronic health record (EHR) systems likely will soon become a fixture in medical settings. Advocates claim they will reduce health care costs and improve medical outcomes, which could be critical since the new health care reform law increases access for millions of Americans. Although benefits of bringing information technology to health records can be substantial, EHR systems also give rise to increased liability risks for health care providers due to possible software or hardware problems or user errors.

Two Case Western Reserve University professors, in a scholarly article published in the Berkeley Technology Law Journal, shed light on liability concerns and electronic health records systems. Sharona Hoffman, professor of law and bioethics and co-director of Case Western Reserve’s Law-Medicine Center, and her husband, Andy Podgurski, professor of computer science at the university’s School of Engineering, previously wrote “E-Health Hazards: Provider Liability and Electronic Health Record Systems,” which offers a comprehensive analysis of the liability risks associated with use of this complex and important technology.

At first glance, a quick transition to digital heath records seems a normal, even an overdue part of the wider flow of high-tech change, the authors write. It may seem surprising that many health care professionals continue to jot down notes and prescriptions on paper. Even so, many doctors might not be fully aware of the fresh liability risk, Podgurski said. Problems providing are can arise, for example, if an EHR system contains software bugs, if it is too complicated, or if training for users is insufficient. “Whether or not there is a software bug, in the sense of a clear error that causes a wrong output, the usability of the system may be lacking, and that may lead a user to make mistakes that have safety implications,” he said.

The authors make a strong case that, without thoughtful intervention and sound guidance from government and medical organizations, EHR technology may encumber rather than support clinicians and may hinder rather than promote health outcome improvements. Congress has made a $19 billion investment in promoting health information technology, provided through the American Recovery and Reinvestment Act of 2009. The US Department of Health and Human Services seeks to achieve nationwide usage of electronic health records by 2014. So now is the best time to consider pitfalls. The authors point out that EHR system purchasers may never know about product flaws, because no regulation requires such disclosure, and some vendor contracts even prohibit it. “If a computer problem causes an error in somebody’s drug prescription, medication dosage or surgical procedure, that can be catastrophic,” Hoffman said.