EHRs More Frequently Factor Into Medical Malpractice Claims, Study Finds

Sept. 4, 2019
While the technology systems are unlikely to be the primary cause of claims, they have become a more prevalent source of risk over the years

The pace of electronic health record (EHR)-related medical malpractice claims has tripled from 2010 to 2018, according to a recent analysis from The Doctors Company, a physician-owned medical malpractice insurance company.

The company uncovered that the frequency of these claims tripled, growing from just seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018.  While EHRs are not often the primary cause of claims—they typically are described as “contributing” factors—and the frequency of claims with an EHR factor continues to be low (1.1 percent of all claims closed since 2010), as EHRs approach near-universal adoption, they may become a more prevalent source of risk, researchers noted.

As such, the study aims to shed light on potential risks they may pose in care delivery, as well as the top factors that contributed to the claims. The study showed that EHR-related claims were caused by either system technology and design issues or by user-related issues, such as EHR failures; lack of or failure of an EHR alert or alarm; fragmented record; insufficient scope/area for documentation in the EHR; failure/lack of electronic routing of data; lack of integration/incompatible systems; and failure to ensure information security.

Among the research’s key findings:

• Top user-related issues stem from incorrect information, pre-populating or copying and pasting, and hybrid health records or EHR conversion (13 percent each).

• Top system technology and design issues were problems with electronic systems and technology failure.

• Of those injuries that occurred in 7 percent or more of claims, adverse reaction to a medication (23 percent) and death (25 percent) were by far the most prevalent.

• Diagnosis-related allegations represented nearly one-third of the total.

• Two specialties—family medicine and internal medicine—received the highest percentage of claims where EHRs are a factor, followed by cardiology and radiology.

Based on the study, Darrell Ranum, vice president of patient safety and risk management at The Doctors Company, identified several steps that organization can take to prevent EHR-related risks that may ultimately contribute to an adverse event, ranging from avoiding copying and pasting except when describing the patient’s past medical history, to contacting your IT department or vendor if you notice that the auto population feature causes erroneous data to be recorded, to reviewing drop-down menu options selected, and more.

“What we have discovered is that allegations of injuries where EHRs are a factor, while a small percentage of overall claims, continue to be a concern as the potential for harm can be catastrophic. Practices should have processes in place to monitor EHR issues and prioritize the need for EHR improvements and redesign based on risk,” said Ranum.

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