System Safety in Healthcare: Electronic Health Records: Dangers for Patient Safety

Dev Raheja; Maria Escano

doi:10.56094/jss.v51i2.154

Authors

Dev Raheja
Maria C. Escano, M.D.

DOI:

https://doi.org/10.56094/jss.v51i2.154

Keywords:

electronic health records, EHR, HIPAA, CDS, system safety

Abstract

Electronic health records (EHR) are critical to precision medicine. They provide greater patient access to medical history data and are available quickly. But there are many inherent risks in using these records.

According to a new study, even in long-standing EHR systems such as the one used by the Department of Veterans Affairs (VA) health care system, many significant EHR-related safety concerns remain. In a study of investigations of EHR-related safety violations launched through the VA’s Informatics Patient Safety office (IPS) from 2009 to 2013, researchers looked at 100 closed cases at 55 VA facilities. Of those cases, 74 involved unsafe technology, and 25 involved unsafe use of technology, which the researchers of the study wrote “most commonly involved the dimensions of people, clinical content, workflow and communication, and human interface.” A majority of cases (70 percent) involved both unsafe technology and unsafe use.

Author Biographies

Dev Raheja

Mr. Dev Raheja has been a System Safety and System Reliability Engineering consultant for over 25 years. His range of consulting encompasses transportation systems, electric power systems, high tech industry, aerospace, defense systems, medical systems, and consumer products. He has conducted training in several countries including Sweden, Australia, Japan, UK, Turkey, Germany, Poland, Singapore, Brazil, South Africa, and Canada. He has done training and consulting work with NASA, U.S. Army, GM, Boeing, Eaton, Nissan Aerospace, Litton, General Dynamics, ITT, BAE Systems, Lockheed-Martin, Harley-Davidson, and United Technologies.

Prior to consulting, Mr. Raheja worked at General Electric, Cooper Industries, and at Booz-Allen & Hamilton. He is the author of several books including Assurance Technologies Principles and Practices (Second Edition, Wiley 2006), and Design for Reliability (Wiley, 2012). A Fellow of the System Safety Society, he has a received Scientific Achievement Award and the Educator-of the-Year Award from the society.

Mr. Raheja serves on the Patient and Families Advisory Council at Johns Hopkins Hospital as a patient safety advocate. He is Associate Editor for Healthcare Safety for The Journal of System Safety and an Associate Professor at University of Maryland where he teaches the “Design For Reliability” course which includes design for safety and trustworthiness.

Maria C. Escano, M.D.

Dr. Maria C. Escano completed her medical degree at University of Miami School of Medicine. She received her post-graduate training at Columbia University/New York Presbyterian Hospital in New York City and St. Agnes Hospital in Baltimore, Maryland. She completed her advanced trauma surgery fellowship at R. Adams Cowley Shock Trauma Center at the University of Maryland.

She has been a regular contributor to scholarly journals for many years and has presented across the country on various topics advocating systems and patient safety initiatives. Dr. Escano is also an extensive traveler, having forged friendships across six continents.