It has been noted that Electronic Health Record (EHR) systems have been widely portrayed as a broad remedy for various patient safety problems in health care, and researchers in the USA have sought to measure the safety performance of operational EHRs in hospitals on a national basis spanning a period 10 years to test this.The researchers used the Health IT Safety Measure test, which uses simulated medication orders that have in real life either injured or killed patients previously, as means to evaluate the effects of EHRs in identifying potentially serious medication errors. Statistics for performance on the assessment test over time were calculated. The study covered 8657 hospital-years, and the mean (SD) scores on the overall test increased from 53.9% (18.3%) in 2009 to 65.6% (15.4%) in 2018. Mean (SD) hospital score for the categories representing basic clinical decision support increased from 69.8% (20.8%) in 2009 to 85.6% (14.9%) in 2018. In the categories representing advanced clinical decision support, the mean (SD) score increased from 29.6% (22.4%) in 2009 to 46.1% (21.6%) in 2018, but there was a lot variation in test performance by EHR.
Evaluation of Computerized Physician Order Entry (CPOE) for medications is incorporated as a part of the EHR evaluation tool. This is routinely assessed because despite intensive efforts, medication safety if still the leading cause of harm due to medical errors in hospital patients. The evaluation tool is a simulation that uses real-world test patients and medication orders to mimic the experience of doctors creating orders for actual patients to evaluate EHR safety performance. Test patients and orders were developed by a group of experts. Orders are divided into 2 categories: those with potential adverse events prevented by basic clinical decision support (drug-allergy, drug-route, drug-drug interactions, drug-dose for single doses, and therapeutic duplication contraindications), and those that would require advanced clinical decision support (ie, drug-laboratory, drug-dose for daily doses, drug-age, drug-diagnosis, and corollary orders contraindications).
The findings of this research are of concern, because broad and costly adoption and optimization of EHR systems, considerable variation in the safety performance of these is demonstrable. Hospitals working with some EHR vendors did better than others, but substantial safety risk persists despite the implementation of the systems. It seems that despite predictions by some, traditional clinical pharmacy services are certainly not rendered obsolete by the advent of CPOE. See the full details here