Complete documentation and timely access to patient information
become possible with the introduction of EHR and thus allows sound clinical
decision making. Other advantages include reduced number of transcription
errors, improved communication among providers, and less duplication of tests.
The adoption of EHRs is
unfolding fast. A varied and shifting landscape of medical liability risks and
benefits can be expected along with the process. Whether these developments
improve the performance of the medical liability system is not clearly known
Implementing a new information system may initially bring up, rather
than decrease, providers' malpractice risk. Increases in computer-related
errors have been documented by several studies. EHR failure may be due to
individual errors or bugs in the software systems.
Electronic documentation enhances the evidence available to
evaluate claims and thus strengthen the accuracy of courts in determining
It is not clearly known at this stage of infancy how the law
may evolve to allocate liability fairly among individual clinicians, EHR
developers, and provider organizations that select and implement EHR systems.
Poorly designed EHR systems will definitely create a negative
impact. Liability that arises due this should rest with those in control of
system architecture and implementation, not end users
. A sub-optimal design
may set the stage for user errors. However in most contracts the developer is
protected from liability arising from the use of the EHR system.
Such contractual provisions that immunize the system developer
can be avoided. Organizations must invest attempt early to ensure that the EHR
system is custom-made to the practice patterns of their clinical staff. Systems
that are designed to minimize the risk of user error or misuse and maximize the
ease of record retrieval may be selected. Another vital aspect to be taken care
of is proper training of clinicians. Physicians must be willing to climb the
learning curve. They should know how using EHRs may help protect them from
liability, and how misuse or non-use may increase liability risk. Organisations
should ensure appropriate practice conditions. Existing barriers to the optimal
use of EHRs must be identified. This includes factors like the placement of
computer terminals, problems accessing external records.
Physicians who function as experts in malpractice litigation can
raise awareness among insurers and courts about the limitations of
clinical-decision support systems and the appropriateness of departures from
them in certain situations.
It is clear that EHR has long-run benefits but
it is tough to quantify the risks and benefits with respect to liability.
Provider organizations must however find ways to weigh the significant up-front
cost and possible risks against the potentially healthy, but uncertain,