The digitalization of health records have brought us all into the future of healthcare, but navigating this new landscape has proven quite tricky; as with all new technology, it has a few kinks to work out before it becomes the all-inclusive healthcare revolution that it was intended to be. While digitalization has streamlined patient information and enabled this information to be more easily shared between clinics and facilities, it has not completely nullified the human error factor as intended. Robert Wachter, Department of Medicine lead for University of California, San Francisco(UCSF), goes into detail on this in an article published on Nature.
“Overall, computers have made safety better. The frequency of medication errors has gone down significantly as we computerized,” says Wachter on the subject. However, digitalization has also made room for additional opportunities for error. For an example, Wachter references a minor patient who received a drug overdose while in the care of UCSF in 2013. The doctor had entered the patient’s dosage in milligrams and failed to acknowledge an alert from the computer that the system expected the dosage in milligrams per kilogram, which is standard procedure for a child. The pharmacist had done the same, signing off on the doctor’s script and dispensing the medication to the nurse, who had seen that the doctor and pharmacist both had signed it and administered the prescribed dosage, which ended up being an overdose of e8 times the dosage.
The culprit? A term now coined in the medical world as ‘alert fatigue’. Wachter believes that such an error as what occurred at UCSF in 2013 could never have happened when paper documentation was the only way simply because “nobody trusted paper,” Wachter says. After the investigation of the 2013 overdose incident at UCSF, it was found that staff members had ignored non essential warnings in the electronic medical record system, setting the groundwork for errors like what had happened to occur.
Also points of concern in the development of this technology is the additional workload it places on providers, forcing them to spend more time entering data and less time with patients. Under scrutiny as well is the security of cloud based patient information.
As more and more healthcare networks adopt electronic recordkeeping, such as the VA has done in an effort to improve healthcare, it is hoped that new methods of learning and advances in technology will reshape the way that data is tracked and communicated. This technology is still relatively new, and as such has a lot more growing to do before it is seen in full capacity.