Kaiser Daily- Jan. 15, 2009

Software glitches in the electronic health records used at a number of Department of Veterans Affairs health care facilities have exposed patients to medical errors, such as incorrect doses of medications or delays in needed treatments, according to an Associated Press investigation, the AP/Boston Globe reports. VA did not disclose the software glitches, which began after an annual upgrade in August and continued through December, to patients, although some of the medical errors that resulted were potentially life-threatening. The software glitches included medical data — such as laboratory results, prescription histories, and vital signs — that appeared in incorrect EHRs and failures to indicate orders from physicians to end treatments.

In a statement issued on Tuesday, VA cited nine cases in which patients received incorrect doses of medications, although no patients appear to have experienced injuries as a result. About one-third of the 153 VA health care facilities have reported some form of software glitch, and department officials have said that many more facilities might have experienced problems but have not filed reports. VA health care facilities began to report the software glitches in early October, and the department began to issue safety alerts by Oct. 10. VA also imposed new safety measures until the department resolved the software glitches in December.

Veterans groups criticized the decision by VA not to disclose the software glitches to patients. Glen Gardner, national commander of the Veterans of Foreign Wars, said, “Being told that no patients were harmed still does not absolve the VA from its responsibility to forewarn patients that something is amiss,” adding, “Trust is paramount in doctor-patient relationships, and nothing should ever be allowed to undermine that confidence.”

Implications
According to the AP/Globe, the software glitches are “more pressing as the federal government begins promoting universal use” of EHRs, as President-elect Barack Obama has “made it a top priority, part of an additional $50 billion a year in spending for health IT programs that he has proposed.” Health care experts said that the software glitches highlight the need for strong oversight of EHRs.

Jeffrey Linder, an assistant professor of medicine at Harvard Medical School, said, “There’s a lot of hype out there about electronic health records, that there is some unfettered good,” adding, “It’s a big piece of the puzzle, but they’re not magic. There is also a potential for unintended consequences” (Yen, AP/Boston Globe, 1/14).