AHRQ guide seeks to reduce unintended EHR consequences

The Agency for Healthcare Research and Quality (AHRQ) has released a guide to reduce unintended consequences of EHRs to address provider problems that can occur when implementing and using an EHR.

“Unintended consequences are not limited to the initial implementation phase,” the guide warned. “They can occur at any time before, during or even long after EHR implementation. Continuously monitoring the functionality and use of the EHR will help anticipate and avoid adverse unintended consequences.”

Based on research literature, AHRQ offered the guide to the public to provide practical, troubleshooting knowledge and resources. Included in the guide are recommended practices for avoiding unintended consequences from a 2008 Joint Commission “Sentinel Event Alert,” including:
  • Actively involving clinicians and staff in the reassessment and ongoing quality improvement of technology solutions;
  • Monitoring continuously for problems and addressing any issues as quickly as possible, particularly problems obscured by workarounds or incomplete error reporting;
  • The use of interdisciplinary brainstorming methods for improving system quality and giving feedback to vendors;
  • Carefully reviewing skipped or rejected alerts;
  • Requiring departmental or pharmacy review and sign off on orders that are created outside the usual parameters; and
  • Providing an environment that protects staff involved in data entry from undue distractions when using the technology.

AHRQ remarked that the guide is a work in progress as the area of research is just burgeoning. Other sections in the guide include guidance on how to monitor EHR usage and clues on EHR update survival.

As an end note, AHRQ stated that the guide represents the opinions of the authors and does not necessarily represent the opinions or best practice recommendations of the AHRQ, the U.S. Government or any of the other organizations with which the authors are affiliated.

The guide was prepared by Rand under contact. Access it here.

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