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Despite their many benefits, Emergency Department Information Systems (EDIS) may also lead to medical errors and cause patient safety and quality concerns

Dosing errors, delay to treat or failure to diagnose a medical condition because of poor interaction between humans and computers or loss of data can result in serious personal injury and wrongful death.

Poor choice or inadequate implementation of Emergency Department Information Systems (EDISs) can threaten health care quality and patient safety. Findings and recommendations from two work groups from the American College of Emergency Physicians were released in a report last Friday in Annals of Emergency Medicine.

The report indicates that The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services “meaningful use” incentive programs as well as additional requirements for detailed reporting of quality metrics have been major catalysts for the development and implementations of EDISs. However systems functionality varies greatly and it is crucial for emergency providers to actively participate in decisions about EDISs selection, implementation and monitoring.

The report identifies communication failure, wrong order – wrong patient error, poor data display and alert fatigue as the most common safety issues. In order to reduce medical errors related to EDIS emergency departments and EDISs vendors should apply the following recommendations:

– Appoint a local ED clinician champion to monitor and improve performance of the EDIS – Create a multidisciplinary EDIS performance group to meet on regular basis and disseminate information about the system throughout the hospital – Set up a review process to monitor ongoing patient safety issues and analyze risk – Patient safety concerns to be reported to and addressed by ED providers, ED vendors and Hospital administration – Share publicly lessons learned from performance improvement efforts with other emergency departments using the same EDIS – EDIS vendor to learn from safety improvements and re-implement necessary changes to all installation sites – “Hold Harmless” or “learned intermediary” clauses to be removed from vendors contracts

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