Electronic Health Records (EHR) are widely used in healthcare in the United States. They are meant to help with keeping patient information, coordinating care, and making healthcare run smoothly. But when hospitals and clinics start using these digital systems, there are risks that can affect patient safety. This part looks at safety problems connected to EHR systems in U.S. healthcare, showing real cases of harm and how they might be fixed, including using artificial intelligence (AI) and workflow automation.
One example comes from the Department of Veterans Affairs (VA). The VA began using a new EHR system created by Oracle Cerner. In 2022, a mistake in this system caused a veteran in Ohio to miss a mental health appointment without proper rescheduling. The VA requires staff to call patients at least three times on separate days if they miss mental health sessions. But because of the system error, this did not happen. The patient stopped treatment, relapsed with substance use, and died.
This was not the only case. The VA’s Office of the Inspector General (OIG) found other serious incidents related to the EHR system, including four deaths. These events showed that technology did not always keep patients safe. Because of this, the VA stopped its EHR update in April 2023, waiting to fix the system so it would work better.
The OIG also said the system made staff work harder, caused repeated tasks, and made communication worse. About 250,000 patients using older EHR systems faced problems linked to pharmacy errors caused by software bugs. These problems went beyond scheduling and included medication safety, which is important because medicine errors cause about half of preventable patient harm in the U.S.
To understand EHR risks, it helps to look at patient safety in general. Around the world, one in ten patients is harmed while getting healthcare. Over three million people die each year because of unsafe care. In the U.S., many harms that can be stopped happen every year. These include medicine mistakes, surgical problems, wrong diagnoses, infections from healthcare, patient falls, pressure sores, and unsafe blood transfusions.
The Organisation for Economic Co-operation and Development (OECD) says over half of patient harm can be prevented. Medicine errors affect about one in every 30 patients. More than a quarter of these errors are serious or could cause death. This shows why medicine safety is a major concern with EHRs, since these systems manage prescriptions, doses, and pharmacy communication.
Human issues like tired staff, poor communication, and not enough training add to the risks caused by system problems or workflows that do not fit well with how care is given. Problems in organizations, such as not enough staff, poorly set-up digital tools, and complicated care tasks, also cause bad events.
The cases at the VA show common problems that happen when hospitals start or upgrade EHR systems. These issues are not just at the VA but happen in many health centers. Some main problems are:
Making EHRs safer needs a wide approach. Medical practice leaders and IT teams can help by focusing on these points:
One way to help is by adding AI and automation to EHR tasks. These tools can lower errors, make admin work easier, and improve communication. This helps reduce patient harm.
For U.S. medical centers, AI and automation can cover gaps caused by human errors and system limits. These tools also help meet federal safety rules by making sure follow-ups and medicine checks happen regularly and correctly.
People who lead medical practices must take charge of managing and improving EHR systems. They need to push for more training, better systems, and patient-focused communication tools. IT teams should secure reliable, easy-to-use EHR setups and add automation when possible. They also need strong systems to detect and report problems quickly.
Because many patient harms can be prevented, leaders must realize that digital health tools can cause risks if not handled well. The VA’s problems warn other healthcare groups to be careful.
Using AI tools like Simbo AI’s phone automation can make managing appointments easier, improve communication, and lighten staff workloads. This helps fix common causes of harm such as missed appointments and poor patient contact. By combining technology with solid policies, healthcare providers can reduce avoidable mistakes and make care safer.
By knowing the risks in EHR use and making changes, medical practices in the U.S. can create safer and more effective patient care systems. Lowering errors in scheduling, medicine, and communication will need teamwork from clinical staff, managers, IT experts, and technology partners.
A scheduling error in the VA’s new electronic health record system contributed to a veteran’s death in Ohio by failing to provide adequate outreach for rescheduling a missed appointment.
The VA’s policy required staff to conduct three telephone calls on separate days for patients with mental health concerns, which was not completed due to a system error.
The failure to reschedule the appointment contributed to the patient’s disengagement from mental health treatment, leading to a relapse and eventual accidental death.
The VA paused the implementation of the EHR Modernization program in April 2023 until it is deemed ‘highly functioning’ amid ongoing issues.
The inspector general disclosed several incidents tied to the EHR system, including catastrophic harm and deaths of veterans in multiple locations.
The report highlighted scheduling system limitations which caused additional work and redundancies, increasing the risk of errors, and identified pharmacy-related patient safety issues.
Approximately 250,000 new EHR site patients who received care at a legacy EHR site were affected by pharmacy-related safety issues due to coding errors.
The inspector general expressed concern that affected patients had not been notified of their risk of harm.
The report indicated mismanagement by staff in evaluating and addressing the patient’s treatment needs, including inadequate ‘caring communications.’
AI is being explored as a potential solution to simplify and enhance appointment scheduling processes for veterans.
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