Word of Caution

Researchers warn that rushing to digitize medical records could increase liability risk for health care providers.

Medical tablet PCs enable healthcare providers to have portable access to digital medical records, but will the digital record-keeping do more harm then good?

To many, electronic health record (EHR) systems certainly seem like a good idea-and like online banking and bill payments, they seem like a natural progression toward a paperless society. Advocates claim electronic records will reduce health care costs and improve medical outcomes, which could be critical as the health care reform law increases access for millions of Americans.

But while the benefits of giving health records a digital makeover can be substantial, possible problems with software or hardware and potential user errors could put health providers at an increased liability risk, according to two researchers from Case Western Reserve University.

Sharona Hoffman, professor of law and bioethics and co-director of Case Western Reserve's Law-Medicine Center, and her husband, Andy Podgurski, professor of computer science at the Case School of Engineering, analyze the liability risks associated with the use of this complex technology in the article "E-Health Hazards: Provider Liability and Electronic Health Record Systems," published in the Berkeley Technology Law Journal.

Hoffman and Podgurski are well known for their research on EHR systems and have published several articles addressing security and privacy issues as well as the need for effective federal regulations to safeguard the quality and safety of the systems.

"This new piece focuses on health care providers' liability," Hoffman says. "Are they at greater risk for malpractice claims? Are they at greater risk for privacy breach claims? And I think the answer to all of that is yes."

Software bugs, overly complex systems, insufficient user training and even outright user errors could all cause problems providing care, according to the researchers.

"If a computer problem causes an error in somebody's drug prescription, medication dosage or surgical procedure, that can be catastrophic," Hoffman says.

The authors argue that without thoughtful intervention and sound guidance from government and medical organizations, electronic health record technology may encumber rather than support clinicians and may hinder rather than promote improvements in health outcomes. To prevent potential problems, Hoffman and Podgurski propose not only federal regulation, but also a uniform process for developing authoritative clinical practice guidelines, and they explore how technology can assist in determining best practices.

Now is the perfect time to consider possible pitfalls in the widespread use of electronic medical records. Congress has made a $19 billion investment in promoting health information technology, provided through the American Recovery and Reinvestment Act of 2009. The U.S. Department of Health and Human Services seeks to achieve nationwide usage of electronic health records by 2014.