Electronic health record-related safety concerns: A cross-sectional survey of electronic health record users

Abstract

Background: The rapid expansion in the use of electronic health records (EHR) has increased the number of medical errors originating in health information systems (HIS). The sociotechnical approach helps in understanding risks in the development, implementation, and use of EHR and health information technology (HIT) while accounting for complex interactions of technology within the health care system. Objective: This study addresses two important questions: (1) "which of the common EHR error types are associated with perceived high- and extreme-risk severity ratings among EHR users?", and (2) "which variables are associated with high- and extreme-risk severity ratings?" Methods: This study was a quantitative, non-experimental, descriptive study of EHR users. We conducted a cross-sectional web-based questionnaire study at the largest hospital district in Finland. Statistical tests included the reliability of the summative scales tested with Cronbach's alpha. Logistic regression served to assess the association of the independent variables to each of the eight risk factors examined. Results: A total of 2864 eligible respondents provided the final data. Almost half of the respondents reported a high level of risk related to the error type "extended EHR unavailability". The lowest overall risk level was associated with "selecting incorrectly from a list of items". In multivariate analyses, profession and clinical unit proved to be the strongest predictors for high perceived risk. Physicians perceived risk levels to be the highest (P