Feinberg
Northwestern Medicine | Northwestern University | Faculty Profiles

News Center

  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Menu
  • Categories
    • Campus News
    • Disease Discoveries
    • Clinical Breakthroughs
    • Education News
    • Scientific Advances
  • Press Releases
  • Media Coverage
  • Podcasts
  • Editor’s Picks
    • COVID-19
    • Cardiology
    • Cancer
    • Neurology and Neuroscience
    • Aging and Longevity
    • Artificial Intelligence in Medicine
  • News Archives
  • About Us
    • Media Contact
    • Share Your News
    • News Feeds
    • Social Media
    • Contact Us
Home » Restrictions on Electronic Medical Records Show Little Benefit
Clinical Breakthroughs

Restrictions on Electronic Medical Records Show Little Benefit

By Will DossJun 26, 2019
Share
Facebook Twitter Email
Bruce Lambert, PhD, director of the Center for Communication and Health in the School of Communication, in collaboration with the Institute for Public Health and Medicine (IPHAM), was a co-author of the study published in JAMA.

Restricting physicians’ ability to view multiple patient records at the same time does not reduce wrong-patient orders, according to a large clinical trial published in JAMA.

Many accrediting agencies and patient safety experts suggest limiting the number of patient records displayed at once, ostensibly to avoid patient misidentification. Instead, the results of this study show that multiple open records may not actually cause wrong-patient orders, according to Bruce Lambert, PhD, director of the Center for Communication and Health in the School of Communication, in collaboration with the Institute for Public Health and Medicine (IPHAM), and a co-author of the study.

Wrong-patient orders are one of the most common medical errors. During 2016 alone, more than 600,000 U.S. patients had an order placed for them that was actually intended for another patient, according to previous studies.

Despite the recommendations of EHR providers, real-world open records practices vary widely. Among a survey of U.S. chief information officers at healthcare providers, just 38 percent reported restricting physicians to viewing a single patient’s record at a time.

In the current study, 3,300 physicians at a large health system in New York were randomly assigned to two groups: half to an EHR configuration that restricted physicians to one patient record at a time, and half to a configuration that allowed up to four patients’ records to be open at once.

The trial coincided with implementation of a new EHR system at all study sites — providing a blank slate for the trial, according to the authors. Near-miss wrong-patient orders were measured through an electronic “retract-and-reorder” query that searched for orders placed for a patient, retracted and then reordered shortly after by the same clinician, but for a different patient.

After two years and over 12 million total orders, investigators found that the proportion of wrong-patient order sessions was virtually unchanged between the restricted and unrestricted groups; 90.7 per 100,000 orders versus 88 per 100,000, respectively.

Notably, even clinicians in the unrestricted group completed 66 percent of orders with just one record open, somewhat limiting the inferences that can be drawn from the study. However, more granular analysis of the data suggest that having multiple open records is a symptom, rather than the cause of the problem, the authors said.

“The underlying problem is likely to be high clinician workload, which influences both the number of open records and the error rate,” said Lambert, who is also a professor of Medical Social Sciences and a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

For example, the rate of wrong-patient orders was lowest in outpatient settings, where clinicians are likely to be caring for a single patient at a time. On the other hand, wrong-patient orders were highest in inpatient critical care and obstetrics units, where physicians are usually juggling multiple patients at once.

“A recent direct observation study demonstrated that multitasking and interruptions were associated with increased rates of prescribing errors, which may be unmeasured confounders in the post hoc analysis reported here,” the authors wrote. “These variations likely reflect differences in workflows and number of patients being cared for simultaneously, and highlight the need for targeted interventions to reduce wrong-patient errors in high-risk settings.”

This project was supported by grant R01HS023704 from the Agency for Healthcare Research and Quality.

Patient Care Public Health Research
Share. Facebook Twitter Email

Related Posts

Evolving Telehealth Research and its Place in Healthcare Delivery 

Dec 8, 2023

Global Health Day Highlights Pandemic, HIV Research

Dec 8, 2023

AI May Spare Breast Cancer Patients Unnecessary Treatments

Dec 7, 2023

Comments are closed.

Latest News

Evolving Telehealth Research and its Place in Healthcare Delivery 

Dec 8, 2023

Global Health Day Highlights Pandemic, HIV Research

Dec 8, 2023

AI May Spare Breast Cancer Patients Unnecessary Treatments

Dec 7, 2023

Drug Extends Survival in Prostate Cancer with Genetic Mutations  

Dec 6, 2023

Pioneering Biochemist Craig Crews Named Winner of 2024 Kimberly Prize

Dec 5, 2023
  • News Center Home
  • Categories
  • Press Release
  • Media Coverage
  • Editor’s Picks
  • News Archives
  • About Us
Flickr Photos
2023-Sim-Open-House_161
2023-Sim-Open-House_127
2023-Sim-Open-House_108
2023-Sim-Open-House_106
2023-Sim-Open-House_118
2023-Sim-Open-House_068
2023-Sim-Open-House_069
2023-Sim-Open-House_027
2023-Sim-Open-House_155
2023-Sim-Open-House_161
2023-Sim-Open-House_127
2023-Sim-Open-House_108

Northwestern University logo

Northwestern University Feinberg School of Medicine

RSS Facebook Twitter LinkedIn Flickr YouTube Instagram
Copyright © 2023 Northwestern University
  • Contact Northwestern University
  • Disclaimer
  • Campus Emergency Information
  • Policy Statements

Type above and press Enter to search. Press Esc to cancel.