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On the Safety of Electronic Medical Records

  • Conference paper
Book cover Foundations of Health Informatics Engineering and Systems (FHIES 2011)

Part of the book series: Lecture Notes in Computer Science ((LNPSE,volume 7151))

Abstract

Information and communication technology is rapidly transforming modern health care systems. Electronic Medical Records (EMRs) systems have replaced traditional forms of storing, processing, interpreting and exchanging patient health information in many health care organizations. However, an increasing number of concerns are raised about the quality of EMR systems and industry regulators are pondering ways to ensure safer health information technologies. This paper discusses fundamental concepts associated with the safety of EMR systems, describes current approaches to regulating the industry, and discusses limitations of traditional safety engineering methods with respect to their application to EMR systems. We then present a domain-specific adaptation of Leveson’s system-theoretic model STAMP for safety engineering of EMR systems and demonstrate its application with a real-world case study.

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References

  1. Standard Practice for System Safety MIL-STD-882E. U.S. Dept. of Defense (2005)

    Google Scholar 

  2. Classification of medical devices class i or class ii patient management software. Health Canada, File number: 10-111648-902, May 21 (2009)

    Google Scholar 

  3. Ammenwerth, E., Shaw, N.: Bad health informatics can kill–is evaluation the answer. Methods Inf. Med. 44(1), 1–3 (2005)

    Google Scholar 

  4. Berger, R., Kichak, J.: Computerized physician order entry: Helpful or harmful? Journal of the American Medical Informatics Association 11(2), 100–103 (2004)

    Article  Google Scholar 

  5. Birtwhistle, R., Keshavjee, K., Lambert-Lanning, A., Godwin, M., Greiver, M., Manca, D., Lagace, C.: Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward. JAMIA 22(4), 412 (2009)

    Google Scholar 

  6. Brown, M., Shaw, N., Grimm, N., Muttitt, S., Gebran, J.: Electronic health records and patient safety: What lessons can canada learn from the experience of others? Healthcare Quarterly 11(1), 112–119 (2008)

    Google Scholar 

  7. Botti, M., Bucknall, T.: Medical error and error in health care. In: Encyclopedia of Medical Decision Making. SAGE Publications (2009)

    Google Scholar 

  8. Chang, A., Schyve, P., Croteau, R., O’Leary, D., Loeb, J.: The jcaho patient safety event taxonomy: a standardized terminology and classification schema for near misses and adverse events. Intl. J. for Quality in Health Care 17(2), 95 (2005)

    Article  Google Scholar 

  9. FDA. Federal register, vol. 76(31), February 15, rules and regulations. 880.6310 - Medical Data Device Rule (2011)

    Google Scholar 

  10. Fried, B.M., Zuckerman, J.M.: Fda regulation of medical software. Journal of Health Law 33(1), 129–140 (2000)

    Google Scholar 

  11. Holden, R.: Cognitive performance-altering effects of electronic medical records: an application of the human factors paradigm for patient safety. In: Cognition, Technology & Work, pp. 1–19 (2010)

    Google Scholar 

  12. Horsky, J., Kuperman, G., Patel, V.: Comprehensive analysis of a medication dosing error related to cpoe. JAMIA 12(4), 377 (2005)

    Google Scholar 

  13. Isaac, T., Weissman, J., Davis, R., Massagli, M., Cyrulik, A., Sands, D., Weingart, S.: Overrides of medication alerts in ambulatory care. Archives of Internal Medicine 169(3), 305 (2009)

    Article  Google Scholar 

  14. Karsh, B., Holden, R., Alper, S., Or, C.: A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional. Quality and Safety in Health Care 15(suppl. 1), i59 (2006)

    Article  Google Scholar 

  15. Kohn, L., Corrigan, J., Donaldson, M., McKay, T., Pike, K.: To err is human. National Academy Press (2000)

    Google Scholar 

  16. Koppel, R., Kreda, D.: Health care information technology vendors’” hold harmless” clause: implications for patients and clinicians. JAMA 301(12), 1276 (2009)

    Article  Google Scholar 

  17. Koppel, R., Metlay, J., Cohen, A., Abaluck, B., et al.: Role of computerized physician order entry systems in facilitating medication errors. JAMA 293(10), 1197 (2005)

    Article  Google Scholar 

  18. Leonard, M., Graham, S., Bonacum, D.: The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care 13(suppl. 1), i85 (2004)

    Article  Google Scholar 

  19. Leveson, N.: A new accident model for engineering safer systems. Safety Science 42(4), 237–270 (2004)

    Article  Google Scholar 

  20. Leveson, N.: Engineering a Safer World - Systems Thinking Applied to Safety. MIT Press (2011)

    Google Scholar 

  21. Leveson, N.G.: Software safety: why, what, and how. ACM Comput. Surv. 18, 125–163 (1986)

    Article  Google Scholar 

  22. Parker, J., Coiera, E.: Improving clinical communication. JAMIA 7(5), 453 (2000)

    Google Scholar 

  23. Phillips, W., Gong, Y.: Developing a Nomenclature for EMR Errors. In: Jacko, J.A. (ed.) HCI International 2009. LNCS, vol. 5613, pp. 587–596. Springer, Heidelberg (2009)

    Chapter  Google Scholar 

  24. Poissant, L., Pereira, J., Tamblyn, R., Kawasumi, Y.: The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. JAMIA 12(5), 505–516 (2005)

    Google Scholar 

  25. Reason, J.: Human error: models and management. Bmj 320(7237), 768 (2000)

    Article  Google Scholar 

  26. Runciman, W., Helps, S., Sexton, E., Malpass, A.: A classification for incidents and accidents in the health-care system. J. Qual. in Clin. Practice 18(3), 199 (1998)

    Google Scholar 

  27. Schaub, G.H., Hoppner, J.: Software and medical devices - recommendation nb-med/2.2/rec4. European Co-ordination of Notified Medical Devices (NB-MED)

    Google Scholar 

  28. Shuren, J.: Testimony of jeffrey shuren. director of fda’s center for devices and radiological health information technology (hit) policy committee. adoption/certification workgroup, February 25 (2010

    Google Scholar 

  29. Smith, M.: The electronic patient record and computer safety. In: Proceedings Strategic Alliances between Patient Documentation and Medical Informatics, AMICE 1995, Rotterdam, Netherlands, pp. 325–331 (1995)

    Google Scholar 

  30. Weber-Jahnke, J.H.: A preliminary study of apparent causes and outcomes of reported failures with patient management software. In: 3rd Intl. Workshop on Software Engineering in Health Care (SEHC). ACM Press (2011)

    Google Scholar 

  31. Williams, J., Weber-Jahnke, J.H.: Medical device regulation and patient management software. Health Law Journal 18(1) (2010)

    Google Scholar 

  32. Zhang, J., Patel, V., Johnson, T., Shortliffe, E.: A cognitive taxonomy of medical errors. Journal of Biomedical Informatics 37(3), 193–204 (2004)

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. University of Victoria, Victoria, BC, V8W 3P6, Canada

    Jens H. Weber-Jahnke & Fieran Mason-Blakley

Authors
  1. Jens H. Weber-Jahnke
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  2. Fieran Mason-Blakley
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Editor information

Editors and Affiliations

  1. International Institute for Software Technology, United Nations University, Casa Silva Mendes, Est. do Engenheiro Trigo No. 4, Macao, China

    Zhiming Liu

  2. Centre for Software Certification, McMaster University, 1280 Main Street West, ITB 202, L8S 4K1, Hamilton, ON, Canada

    Alan Wassyng

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© 2012 Springer-Verlag Berlin Heidelberg

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Weber-Jahnke, J.H., Mason-Blakley, F. (2012). On the Safety of Electronic Medical Records. In: Liu, Z., Wassyng, A. (eds) Foundations of Health Informatics Engineering and Systems. FHIES 2011. Lecture Notes in Computer Science, vol 7151. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32355-3_11

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  • DOI: https://doi.org/10.1007/978-3-642-32355-3_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-32354-6

  • Online ISBN: 978-3-642-32355-3

  • eBook Packages: Computer ScienceComputer Science (R0)

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