MedStar Health Researchers Investigate Alleged Misrepresentation of EHR Capabilities With Potentially Far-reaching Implications for Patient Safety

A research letter available today in JAMA Health Forum advocates for stricter safety practices among EHR providers.

COLUMBIA, Md., November 11, 2022 /PRNewswire/ — Researchers at MedStar Health, Brigham and Women’s Hospital, and the University of Utah found that electronic health record (EHR) vendor misconduct may have led to widespread use of suboptimal products for more than 70,000 clinicians across the country, as published today in JAMA Health Forum. Six EHR vendors were involved in settlements with the US Department of Health and Human Services’ Office of the Inspector General and the US Department of Justice that alleged kickbacks and misrepresentation of product capabilities.

In addition to creating incentives for healthcare organizations to adopt the use of EHRs, the Health Information Technology for Economic and Clinical Health Act of 2009 deemed EHR products subject to being certified to meet capability, functionality, and security requirements which has been accepted by HHS. Violation of this rule can lead to complaints and in turn settlements with DOJ, but unfortunately oversight is limited.

After reviewing every publicly available settlement related to EHR certification violations, MedStar Health researchers found that six EHR vendors reached settlement agreements totaling more than $379.8 million dollars, with four of the six suppliers involved in settlements related to misrepresenting product functionality to secure certification. Based on data from the Centers for Medicare & Medicaid, it is estimated that more than 76,831 unique clinicians used these six providers during the period of the complaints.

“The expanded use of EHRs has helped providers and healthcare organizations better manage care for their patients. But what happens if providers can’t trust that the EHR platform they use is safe, secure, and can be used effectively?” said Raj Ratwani, PhD., vice president of scientific affairs for MedStar Health Research Institute, director of the MedStar Health National Center for Human Factors in Healthcare and senior author on this paper. “These data show that even a handful of examples of bad behavior by EHR providers can have far-reaching impacts on patient safety and how providers use these platforms.”

Insights to make EHRs more secure

Today’s publication builds on the MedStar Health human factors team’s exploration of the role that EHR systems can play as a contributing factor to overall patient safety, including a 2018 study that found that EHR usability challenges may have contributed to harm in some health care facilities.

In addition to examining EHR design, MedStar Health investigators sought to develop actionable solutions to make EHRs more secure through two main initiatives:

1) Develop resources for healthcare facilities to proactively monitor and identify opportunities to optimize the functionality of their EHR platform. This most recently includes building an assessment tool that can be used to evaluate alerting, data entry and automation processes and visual display.

2) Offers recommendations for stricter safety standards across the EHR market. Examples of this work include requiring HHS to develop a national database for usability and safety reporting and encouraging the Joint Commission to adopt accreditation requirements that would incentivize hospitals to implement EHR safety best practices.

“The importance of our work in this area is that we can improve EHRs as a critical tool for healthcare facilities and patient safety at the same time,” said Dr. Ratwani said. “While we have made incremental progress, success is dependent on greater transparency across the industry, as well as a shared commitment from governing bodies, health system customers and providers to work together to prioritize safety.”

Ratwani RM, Apathy NC, Bates DW, Classen DC, Hettinger AZ, Howe JL, Krevat SA. Electronic Health Record Legal Settlements in the US Since the 2009 Health Information Technology for Economic and Clinical Health Act. JAMA Health Forum. 2022;3(11):e223872. doi:10.1001/jamahealthforum.2022.3872

About MedStar Health

At MedStar Health, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. Our 30,000 associates and 4,700 affiliated physicians are committed to delivering on this promise through our core SPIRIT Values—Service, Patient First, Integrity, Respect, Innovation and Teamwork—across our more than 300 locations, including 10 hospitals, ambulatory and urgent care centers. As the medical education and clinical partner of Georgetown University, MedStar Health trains future physician leaders to care for the whole person and promotes care through theMedStar Health Research Institute. From our telemedicine and urgent care services to the region’s largest home health agency, we are committed to providing high-quality healthcare that is also easy and convenient for our patients. At MedStar Health—This is how we treat people. Learn more atMedStarHealth.org.

SOURCE MedStar Health

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