Decreasing Medication Errors with Decreasing Medication Errors with

Electronic Medical Records (EMRs)Electronic Medical Records (EMRs) Decreasing Medication Errors with Decreasing Medication Errors with

Electronic Medical Records (EMRs)Electronic Medical Records (EMRs)

Group 4B: Jason, Karen, Steven, Thu, Thienan, Selamawit, Meaghan, Chirs & Michelle

Objectives

Explain medical errors and EMRs

Understand how errors are made

Determine how EMRs can help

Identify the advantages and disadvantages

Discuss the future of EMRs in the medical field

Introduction

What is considered a medical error?

Consequences of medical errors

Death

Excess spending

Unnecessary time, energy and added stress

What is an EMR?

Alternative names are: EHR, EPR, CPR

How are errors made?

Prescription Errors

Poor Penmanship

Error-prone abbreviation

Dosing errors

Failure to follow prescription guidelines

Lack of knowledge

Dispensing Errors

Look alike/sound alike

Busy workplace

Failure to spot mistake

Patient counseling

Administration Errors

Omissions

Repetition

Substitutions

Wrong patient!

Insertion

Incorrect Dosage

Incorrect Route

Other

How does EMR reduce errors?

Dispensing Errors

Improved data integrity:

Better organized

Easier to access client information

Use of required fields, uniform data entry and trained personnel

Prescribing Errors: Safety

Drug-to-drug interactions

Drug-allergy interactions

Drug-disease incorrect dosage

Incorrect duration

Drug-pregnancy conflict

Drug gender conflict

OTC drugs & herbal  adverse interactions.

Prescribing Errors: Productivity

Available strength of drug

Alternative class medications

Reduce refill time

Provide patient data surveillance

Formularies are available electronically

Dispensing Errors

Complete prescription information

Less errors in interpreting

Quicker access to provider

Quicker refill authorization

More access to patient’s profile

Safety ErrorsDrug-to-drug interactions

Drug-allergy interactions

Drug-disease incorrect dosage

Incorrect duration

Drug-pregnancy conflict

Drug gender conflict

Advantages of EMRs

Advantages Efficiency:

Retrieve patient profiles quicker

Patient access to profiles

Reduce errors

Easy to transfer information:

Ex: In natural disasters like Hurricane Katrina or 9/11

Ex: If practice has closed or relocated

Advantages

Saves money:

Cost of filing folder and paper

Cost of labor

Patients saving money

Easier billing

Saves space:

Faster work flow

Disadvantages of EMRs

Financial Issues

High Initial implementation cost:

Time and patients lost

Cost of retained paper processes after

Cost of training

Uncertain return on investment

Personal Issues

Lack of physician support for EMRs

Technical matters:

Difficulty using new software

Lack of support for technical difficulties

Inadequate consistency of electronic records

Security Issues

Lack of medical policy specific to EMRs

Potential threats:

“Inside attacks”

Information hungry employers

Insurance companies

EMR Advancements and Policies

Advancements in EMR

Tablet integration in healthcare

Check in

Data entry

Medical speech recognition solutions

Role of smartphones in healthcare

Policies Regarding EMRsEMR government mandate:

2014 deadline

Penalties for failing

Federal incentive program:

17.2 billions in funds

Certified EMR

Eligibility

Meaningful use: Interoperability

Implementing EMRsHigh failure rate:

Takes months to properly install

Choosing a vendor:

Practice fusion

High cost:

Hire IT and consultants

Training

Questions??

References1. "Avoid common pitfalls of implementing EMRs." Managed Care Contracting and

Reimbursement Advisor Oct. 2011: 5+. Health Reference Center Academic. Web. 6 Mar. 2012. <http://go.galegroup.com.ezproxy.mcphs.edu/ps/i.do?id=GALE%7CA273587153&v=2.1&u=mcp_main&it=r&p=HRCA&sw=w>

2. Barrows, Randolph C., Jr., and Pail D. Clayton. "Privacy, Confidentiality, and Electronic Medical Records."Journal of the American Medical Informatics Association. 3.2 (1996): 139-148. Web. 5 Feb 2012. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC116296/pdf/0030139.pdf>.

3. Bowdie, TA. "Drug Administration Errors from ASA CLosed Claims Project." ASA Newsletter. 67.6 (2003): 11-13. Web. 22 Feb 2012. <http://depts.washington.edu/asaccp/ASA/Newsletters/asa67_6_11_13.pdf>. 

4. Buppert, Carolyn. "Electronic Medical Records: 18 Ways to Reduce Legal Risks." Medscape News Pharmacists. (2010): n. page. Web. 22 Feb. 2012. <http://www.medscape.com/viewarticle/714812>.

5. "Dispensing Errors – Dispensing Process." NHS Wirral. N.p., n.d. Web. 5 Mar 2012. <http://www.wirral.nhs.uk/document_uploads/Governance/DispensingErrorsAudit.pdf>.

6. Fins, Joseph J. "Web of Care: How Will the Electronic Medical Record Change Medicine?." Hastings Center Report. 38.5 (2008): 36-38. Web. 5 Mar. 2012. <http://www.medscape.com/viewarticle/714812>.

References7. Graham, Angie S. "Prescribing Errors." California Journal of Health-System

Pharmacy. (2008): 5-14. Web. 1 Mar. 2012. <http://www.cshp.org/uploads/file/Continuing%20Education/CJHP%20CE/v20n2_ce_prescribing_errors.pdf>

8. Hebda, Toni, Patrica Czar, and Cynthia Mascara. Handbook of informatics for Nurses and Health Care Professionals. 3. New Jersey : Person, Prentice Hall., 2005. 256-258. Print.

9. Jha, A.K., DesRoches, C.M., Campbell, E.G., Donelan, K., Rao, S.R., Ferris, T.G., Shields, A., Rosenbaum, S., Blumenthal, D. "Use of Electronic Health Records in U.S. Hospitals." New England Journal of Medicine. 360.16 (2009): 1628-1638. Web. 10 Feb 2012. <http://www.nejm.org/doi/full/10.1056/NEJMsa0900592>

• Jones, D. Scott, and Howard B. Kessler. "Can electronic medical records really improve quality? The Obama administration bets yes: step right up, physicians--the electronic medical record wizard is waiting for you." Journal of Health Care Compliance Jan.-Feb. 2010: 39+. Health Reference Center Academic. Web. 3 Mar. 2012. http://go.galegroup.com.ezproxy.mcphs.edu/ps/i.do?id=GALE%7CA216180883&v=2.1&u=mcp_main&it=r&p=HRCA&sw=w

7. "Medication Errors." FDA Drug Safety Newsletter. 1.4 (2008): n. page. Web. 3 Mar. 2012. <http://www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/ucm120618.htm>.

References12. Microwize Technology, Inc."Reducing Medical Errors with an Electronic

Medical Records System." Sunrise Services. N.p., n.d. Web. 12 Feb 2012. <http://www.sunrize.com/ReducingMedicalErrorsForum.pdf>.

13. Miller, Robert H. and Sim, Ida. “Physicians’ Use of Electronic Medical Records: Barriers And Solutions.” Health Affairs, 23. 2 (2004): 116-126. Web. 20 Feb. 2012. <http://content.healthaffairs.org/content/23/2/116.full>

14. Rama P. Nair Daya Kappil, and Tonja M. Woods. "10 Strategies for Minimizing Dispensing Errors." Pharmacytimes. HCPLive, n.d. Web 4 Mar. 2012. <http://www.pharmacytimes.com/media/pdf/P2PdispensingErrors.pdf>

15. Rivera, Pete. "Emr? We have an iPhone app for that ..." Healthcare Informatics Mar. 2010: 10.Health Reference Center Academic. Web. 6 Mar. 2012 <http://go.galegroup.com.ezproxy.mcphs.edu/ps/i.do?id=GALE%7CA221935605&v=2.1&u=mcp_main&it=r&p=HRCA&sw=w.>

References• Sanderson, Susan. Electronic Health Records for Allied Health Careers. Boston:

McGraw-Hill Higher Education, 2009. 28-30, 98- 103. Print.

• Smith, Paul D. "Implementing an EMR System: One Clinic’s Experience." Family Practice Management. 10.5 (2003): 37-42. Web. 6 Mar. 2012. <http://www.aafp.org/fpm/2003/0500/p37.html>.