Efficiency and Safety of Electronic Health Records in Switzerland-A Comparative Analysis of 2 Commercial Systems in Hospitals.

Fischer, Simone; Schwappach, David L. B. (2022). Efficiency and Safety of Electronic Health Records in Switzerland-A Comparative Analysis of 2 Commercial Systems in Hospitals. Journal of patient safety, 18(6), pp. 645-651. Wolters Kluwer Health 10.1097/PTS.0000000000001009

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OBJECTIVES

Differences in efficiency and safety between 2 electronic health record (systems A and B) in Swiss hospitals were investigated.

METHODS

In a scenario-based usability test under experimental conditions, a total of 100 physicians at 4 hospitals were asked to complete typical routine tasks, like medication or imaging orders. Differences in number of mouse clicks and time-on-task as indicators of efficiency and error type, error count, and rate as indicators of patient safety between hospital sites were analyzed. Time-on-task and clicks were correlated with error count.

RESULTS

There were differences in efficiency and safety between hospitals. Overall, physicians working with system B required less clicks (A: 511, B: 442, P = 0.001) and time (A: 2055 seconds, B: 1713 seconds, P = 0.055) and made fewer errors (A: 40%, B: 27%, P < 0.001). No participant completed all tasks correctly. The most frequent error in medication and radiology ordering was a wrong dose and a wrong level, respectively. Time errors were particularly prevalent in laboratory orders. Higher error counts coincided with longer time-on-task (r = 0.50, P < 0.001) and more clicks (r = 0.47, P < 0.001).

CONCLUSIONS

The variations in clicks, time, and errors are likely due to naive functionality and design of the systems and differences in their implementation. The high error rates coincide with inefficiency and jeopardize patient safety and produce economic costs and burden on physicians. The results raise usability concerns with potential for severe patient harm. A deeper understanding of differences as well as regulative guidelines and policy making are needed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Schwappach, David

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1549-8417

Publisher:

Wolters Kluwer Health

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

15 Sep 2022 20:37

Last Modified:

03 Sep 2023 00:25

Publisher DOI:

10.1097/PTS.0000000000001009

PubMed ID:

35985044

BORIS DOI:

10.48350/172980

URI:

https://boris.unibe.ch/id/eprint/172980

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