Challenges In Patient Safety Improvement Research In The Era Of Electronic Health Records

Authors: Elise Russo, Dean F. Sittig, Daniel R. Murphy, Hardeep Singh

Abstract:

Electronic health record (EHR) data repositories contain large volumes of aggregated, longitudinal clinical data that could allow patient safety researchers to identify important safety issues and conduct comprehensive evaluations of health care delivery outcomes. However, few health systems have successfully converted this abundance of data into useful information or knowledge for safety improvement. In this paper, we use a case study involving a project on missed/delayed follow-up of test results to discuss real-world challenges in using EHR data for patient safety research. We identify three types of challenges that pose as barriers to advance patient safety improvement research: 1) gaining approval to access/review EHR data; 2) interpreting EHR data; 3) working with local IT/EHR personnel. We discuss the complexity of these challenges, all of which are unlikely to be unique to this project, and outline some key next steps that must be taken to support research that uses EHR data to improve safety. We recognize that all organizations face competing priorities between clinical operations and research. However, to leverage EHRs and their abundant data for patient safety improvement research, many current data access and security policies and procedures must be rewritten and standardized across health care organizations. These efforts are essential to help make EHRs and EHR data useful for progress in our journey to safer health care.

Citation: Elise Russo, Dean F. Sittig, Daniel R. Murphy, Hardeep Singh Challenges In Patient Safety Improvement Research In The Era Of Electronic Health Records http://dx.doi.org/10.1016/j.hjdsi.2016.06.005

Received: 7 December 2015, Revised: 6 June 2016, Accepted: 18 June 2016, Available online: 26 July 2016

Copyright: © 2016 Published by Elsevier Inc.This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Funding

Dr. Singh is supported by the VA Health Services Research and Development Service (CRE 12-033; Presidential Early Career Award for Scientists and Engineers USA 14-274), the VA National Center for Patient Safety, the Agency for Health Care Research and Quality (R01HS022087 and R21HS023602), and the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413). Drs. Sittig and Singh are supported in part by a grant from the Agency for Health Care Research and Quality (P30 HS024459).

Conflict of interest statement

This statement accompanies the article Challenges in patient safety improvement research in the era of electronic health records, authored by Hardeep Singh and co-authored by Elise Russo, Dean F. Sittig, Daniel R. Murphy and submitted to Healthcare as an Article Type. Authors collectively affirm that this manuscript represents original work that has not been published and is not being considered for publication elsewhere.We also affirm that all authors listed contributed significantly to the project and manuscript. Furthermore we confirm that none of our authors have disclosures and we declare no conflict of interest. ?>Consultant arrangements: None ?>Stock/other equity ownership: None ?>Patent licensing arrangements: None ?>Grants/research support: None ?>Speakers' bureau: None ?>Expert witness: None.