EHR

Electronic health records are increasingly being cited in medical malpractice lawsuits, Politico reports.

According to a review of data by the Doctors Company, a physician-owned medical malpractice insurer, EHRs were involved in just 1% of a sample of lawsuits that had been closed between 2007 and 2013. However, the frequency of such EHR-related lawsuits doubled between 2013 and 2014.

According to Politico, the numbers of existing cases could be higher because it often takes up to six years to conclude a case.

Doctors Company Medical Director David Troxel said that while the percentage of EHR-related lawsuits remains comparatively low, "this is going to become a bigger and bigger issue."

EHR Lawsuit Details

According to Politico, the lawsuits alleged a variety of mistakes caused by EHRs, including:

• Faulty voice-recognition software;
• Misinterpretation of EHR drop-down menus;
• Reliance on outdated or incorrect records; and
• Typos that led to medical errors (Allen, Politico, 5/4).

Further, some EHR systems are designed in a way that can prompt errors, according to Computerworld. For example, diagnosis drop-down menus can automatically enter data if a cursor hovers over a specific item for too long (Mearian, Computerworld, 4/13).

Targets of Lawsuits

According to Politico, health care professionals are typically the targets of such lawsuits because of contract agreements that exempt vendors from most legal liability under a "learned intermediary" doctrine. Such agreements are based on the idea that while information systems store the data and sometimes provide clinical decision support, the responsibility lies with the actual provider.

However, analysts predict that providers and health systems will start suing vendors, in part because of the potential to recover large sums in damages.

Keith Klein, a professor of medicine at the University of California-Los Angeles, said, "It's only a matter of time before a company like athenahealth or Allscripts or Epic or Cerner gets sued."

According to Scot Silverstein, a health IT expert at Drexel University, lawyers are already considering such cases.

Effect of EHR-Related Malpractice Cases

According to Politico, the effect of EHRs on malpractice lawsuits remains "modest."

However, some analysts have expressed concern about the uncertainty that surrounds EHR data. According to Politico, EHR errors and inaccuracies could:

• "[C]ast doubt" on physicians; and
• Diminish clinical research that relies on large pools of data.

Michael Victoroff, a liability expert, said he believes the U.S. eventually will need a settlement fund to be drawn from to compensate for injuries to patients stemming from EHR-related cases (Politico, 5/4).

Athenahealth, Epic and Medfusion are the best electronic health record vendors for helping to facilitate patient portal adoption among their customers, according to a new KLAS report, Becker's Health IT & CIO Review reports (Jayanthi, Becker’s Health IT & CIO Review, 4/24).

Details of Report

The report was based on interviews with 186 provider organizations. The organizations were asked about the extent to which their EHR vendors helped to meet their current needs and helped to develop strategic solutions for the future (KLAS release, 4/23).

The report analyzed EHR vendor performance on three types of patient portal strategies:

• Ambulatory;
• Enterprise; and
• EHR agnostic.

Report Findings

KLAS found that athenahealth, Epic and Medfusion each had more than half of their customers report that 20% or more of their patients accessed patient portals -- well above the current requirement under Stage 2 of the meaningful use program.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Under Stage 2, providers must have 5% of their patients view, download and transmit their health data through patient portals. However, CMS has proposed new Stage 2 rules that would reduce that requirement to a single patient per provider.

According to report author Coray Tate, providers said that the most effective means of encouraging patient portal adoption were:

• Guidance from vendors; and
• Functionality that patients found useful, such as self-scheduling and billing (Gruessner, EHR Intelligence, 4/28).

The electronic health record market reached nearly $25 billion in 2014 and is likely to continue growing over the next four years, according to a report by Kalorama Information, Healthcare IT News reports (Monegain, Healthcare IT News, 4/28).

Report Details

According to the report, EHR sales increased by 10% between 2012 and 2014, reaching $24.9 billion. The report attributes the growth in large part to hospitals and providers acquiring updated EHR systems.

Among physicians, EHR adoption rates increased from 57% in 2011 to 81.4% in 2014.

Meanwhile, the report projected that the EHR market will grow to $35.2 billion by 2019.

The report said the estimated growth likely would be driven by:

• Continued EHR adoption among hospitals;
• Increased adoption to meet meaningful use Stage 3 requirements (Jayanthi, Becker's Health IT & CIO Review, 4/17); and
• Payment reductions under the incentive program for failing to adopt EHRs.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

The report said that "fear of reimbursement loss will end up driving adoption more than incentives for extra reimbursement."

It added, "Growth will continue at approximately 13.4% for 2015-2019 as the 'carrot' of incentives tempts physicians but most importantly as the 'stick' of penalties threaten to impact 2015 revenues" (Healthcare IT News, 4/28).