When a health care organization embarks down the road to implementing an electronic health record system (EHR), the main goals ordinarily focus on organizational efficiency, controlling costs and improving patient care outcomes. It is important these goals remain balanced throughout the implementation process and organizations stay clear of generating great efficiency improvements and cost saving at the expense of patient safety.

One of the greatest benefits an organization will see from an EHR is organizational efficiency which in turn directly correlates to cost savings. As workflows and processes see efficiencies, less people may need to deal with administrative tasks like assembling patient charts. Entering data at the point of care, for instance, allows the updated patient data to be available to all required parties (nutritionists, pharmacists, etc.) when and where it is needed throughout the organization. This creates efficiencies that span departments throughout the entire health care organization.

EHR systems allow for a variety of features that speed the entry of data, allow for data entry at the point of care. For instance, a list can be used to bring less used clinical concepts into an existing template, for entering data into the EHR at the point of care. Cut and past and record cloning are other examples of data entry methods that can speed the entry of data. However, it should be noted that each of these techniques and technologies should be thoroughly vetted before they are implemented. If not done properly, these time saving tools and techniques can have grave consequences for patient safety.

Imagine a data entry clerk creating new patient records for a large family. All of the siblings have nearly identical demographic information within their patient records. The EHR interface designer would be able to see such a situation and design an interface optimal for creating new patients, but must pay attention to the possibility of entering in incorrect values for critical fields. The designer could offer a function “Create New Patient from Last Patient” for cloning one patient record into another. Using this function would display the New Patient screen but all filled in with the last patient’s information. The clerk could then go through and modify the fields they know to be different (first name, middle name, date of birth, gender, etc.). The risk being, the clerk, in a rush to complete the entry for all the patients, make take short cuts. They may, for instance, forget to change the date of birth on a particular sibling causing date based alerts not to function properly. This could cause the malformation of an immunization schedule for example. Even seemingly benign data entry errors can have a drastic negative impact. It is important health care information systems assist with data entry but in no circumstances should they perform the data entry.

When a health care organization begins the process of implementing an EHR, it is paramount policies and procedures be in place around data entry. These policies and procedures must keep in balance the critical imperative of patient safety with the other factors necessitating the implementation of an EHR. Increased cost savings at the behest of vastly improved organizational efficiency is only beneficial if patient safety and patient outcomes are also improved, or at very least not diminished.

Gartee, R. (2017). Electronic health records: understanding and using computerized medical records. NY, NY: Pearson.

Wager, K. A., Lee, F. W., Glaser, J. P., & Wager, K. A. (2009). Health care information systems: A practical approach for health care management. San Francisco, CA: Jossey-Bass.

Robert J. Fawcett September 26, 2017