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Health Aff (Millwood). 2018 Nov;37(11):1752-1759. doi: 10.1377/hlthaff.2018.0699.

Identifying Electronic Health Record Usability And Safety Challenges In Pediatric Settings.

Author information

1
Raj M. Ratwani ( raj.m.ratwani@medstar.net ) is director of the National Center for Human Factors in Healthcare, MedStar Health, and an assistant professor of emergency medicine, Department of Emergency Medicine, Georgetown University School of Medicine, both in Washington, D.C.
2
Erica Savage is a manager in Ambulatory Quality and Safety, MedStar Health.
3
Amy Will is a research program manager at the National Center for Human Factors in Healthcare, MedStar Health.
4
Allan Fong is a research scientist at the National Center for Human Factors in Healthcare, MedStar Health.
5
Dean Karavite is principal human computer interaction specialist, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, in Pennsylvania.
6
Naveen Muthu is director of the Cognitive Informatics Group, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, and an instructor of pediatrics, University of Pennsylvania Perelman School of Medicine.
7
A. Joy Rivera is a senior human factors system engineer at the Children's Hospital of Wisconsin, in Milwaukee.
8
Cori Gibson is a safety specialist at the Children's Hospital of Wisconsin.
9
Don Asmonga is an officer in the Health Information Technology Initiative, Pew Charitable Trusts, in Washington, D.C.
10
Ben Moscovitch is the project director of the Health Information Technology Initiative, Pew Charitable Trusts.
11
Robert Grundmeier is director of clinical informatics, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, and an assistant professor of pediatrics, University of Pennsylvania Perelman School of Medicine.
12
Josh Rising is director of Healthcare Programs, Pew Health Group, Pew Charitable Trusts.

Abstract

Pediatric populations are uniquely vulnerable to the usability and safety challenges of electronic health records (EHRs), particularly those related to medication, yet little is known about the specific issues contributing to hazards. To understand specific usability issues and medication errors in the care of children, we analyzed 9,000 patient safety reports, made in the period 2012-17, from three different health care institutions that were likely related to EHR use. Of the 9,000 reports, 3,243 (36 percent) had a usability issue that contributed to the medication event, and 609 (18.8 percent) of the 3,243 might have resulted in patient harm. The general pattern of usability challenges and medication errors were the same across the three sites. The most common usability challenges were associated with system feedback and the visual display. The most common medication error was improper dosing.

KEYWORDS:

Electronic health records; Information Technology; safety; usability

PMID:
30395517
DOI:
10.1377/hlthaff.2018.0699
[Indexed for MEDLINE]

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