EHR use linked to fewer medical liability claims

As physicians and medical liability attorneys continue to weigh the potential risks involved with electronic health record use, some researchers say physicians can rest assured: EHRs will not increase their risk of malpractice claims. In fact, they can reasonably expect their risk to decrease, they said. But others say physicians should proceed with caution.

A research letter published online June 25 in Archives of Internal Medicine found that the rate of liability claims when EHRs were used was one-sixth the rate when EHRs were not used. Researchers say their findings suggest there was a reduction in errors associated with EHR use.

For the study, 275 Massachusetts physicians were interviewed in 2005 and 2007. Thirty-three had a total of 51 claims filed against them; 49 of the claims were related to events that occurred before EHR adoption. Two claims involved events that occurred after EHR adoption.

The study was a follow-up to one conducted in 2008 by the same team who researched the same group of physicians. The survey, which looked at the number of claims filed, said physicians using EHRs had lower rates of paid liability claims.

“It’s entirely possible that there’s something still distinct and unusual about practices that adopted electronic health records earlier, and they just happen to practice in a way that reduces their risk of malpractice claims,” said Steven Simon, MD, MPH, an internist at the VA Boston Healthcare System and co-author of the report. “But I think it’s equally plausible that there’s something about electronic health records that does reduce their risk.”

Determining risks

EHRs have helped to significantly reduce errors in medicine, but mistakes will never go away, said Dean F. Sittig, PhD, professor in the School of Biomedical Informatics at the University of Texas Health Science Center at Houston.

He cautioned doctors about over-reliance on technology. “Sometimes people, I think, feel that & now that we have a computer we will not make any more errors.”

Sittig is working with the American Health Lawyers Assn. on a research project that will look at the potential risks associated with EHR use and how the risks can be prevented or minimized.

Mark Anderson, CEO of AC Group, a health care technology and research firm in Montgomery, Texas, said he has found the level of risk depends on the EHR system and how it is used.

Physicians have been asked to adopt EHRs that have been certified to meet meaningful use criteria, but the certification requirements do not include liability risk assessments, Anderson said. He has been evaluating EHR systems for liability risks for several years and said a small number of vendors have designed good systems. These vendors have been in business the longest and are probably the ones many of the surveyed Massachusetts physicians are using, given the early adoption rates in the state, he said.

Sittig said improper use of EHRs can lead to bad outcomes. Each system has to be configured for each user and situation. Identifying potential problems will help physicians make the needed changes, he said.

“We want no mistakes in medicine. That’s the point,” he said.

Dr. Simon expects more research into the relationship between EHRs and medical liability lawsuits now that more physicians have been exposed to EHRs for longer periods.

The time between an adverse event and the filing of a malpractice claim can be several years, and that has hampered research efforts, he said.

“I would predict & in the next couple of years we will see a larger, national study that will add to this and be even more generalized than ours is,” Dr. Simon said.