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

Preview	Text Fischer_JPatientSaf_2022_AAM1.pdf - Accepted Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (218kB) | Preview
	Text Fischer_JPatientSaf_2022.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (182kB)

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.

Interest & Impact

Downloads

86 since deposited on 15 Sep 2022
78 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item