A Constrained Review of Safety Analyses of Electronic Medical Record Use and Recommendations for Enhanced Design

Previous research has found that the use of properly designed and implemented Electronic Medical Records (EMRs) can promote safety culture in primary care providers. However, there remain concerns that such technology may also create new safety issues that could lead to patient harm. The objectives of the present research were to: (1) summarize studies that identified potential hazards in EMR use as well as those making use of safety analysis techniques for hazard identification; and (2) formulate a set of design recommendations and an enhanced design to mitigate user performance problems and potential patient safety hazards. Results revealed the main types of hazards in EMR use to be poor display of information and erroneous data entry and documentation methods. In addition, all hazard analyses conducted in previous studies employed inductive reasoning methods. It was also found that studies focusing on EMR system safety made no objective assessments and basically made use of descriptive and qualitative methods.뀀ഀȠWe proposed an enhanced EMR interface design towards mitigating the safety issues identified in the literature. This research is complementary to other work we recently completed on EMR usability issues and enhanced design recommendations. We also recommended use of objective and deductive reasoning approaches to assess the frequency of potential hazards and to identify potential severity of outcomes for patients. Practitioner Summary: An enhanced EMR interface design is proposed based on a review of literature and recognition of potential hazards to patients in use of existing designs. Results may be beneficial for companies developing EMRs for healthcare providers in order to design interfaces that effectively support safety in healthcare worker interaction with EMR systems.