EHR Usability May Contribute to Patient Harm; Further Research Warranted

​A study published in the March 27, 2018, issue of JAMAanalyzed reports of patient harm that specifically mentioned a major electronic health record (EHR) vendor or product and found that EHR usability may play a role in some patient harm events. The authors analyzed more than 1.7 million adverse event reports submitted to the Pennsylvania Patient Safety Authority database between 2013 and 2016 and reports from a multihospital academic healthcare system in the mid-Atlantic, outside of Pennsylvania. Reports were included for analysis if one of the top five EHR vendors was mentioned and if the report contained language explicitly suggesting that EHR usability contributed to possible patient harm. The authors then categorized each of the 557 reports that met these criteria as one of seven usability issues: data entry (27%), alerting (22%), interoperability (18%), visual display (9%), availability of information (9%), system automation and defaults (8%), and workflow support (7%). The authors acknowledge that only a small percentage of potential harm events were associated with EHR usability; however, they state that safety reports capture only a small number of actual safety incidents.