A report from the Health Services Safety Investigations Body finds that there are often problems with electronic patient record systems. 

An investigation report from the Health Services Safety Investigations Body (HSSIB) highlights how electronic patient record (EPR) systems still contribute to patient care being missed, delayed or recorded incorrectly. This is despite national recommendations and actions intended to reduce risks.

The review aimed to identify where EPR systems had been considered in reports, the problems associated with them and their impact on patient safety. The review also revisited the safety recommendations and safety observations we have made that relate to EPR systems.

“This report is not a criticism of EPRs themselves,” said senior safety investigator Nick Woodier. “When implemented well, they can bring benefits for patient safety. However, the analysis of our past investigations shows that systems which are poorly implemented, difficult to use, or do not meet the needs of staff and organisations can introduce avoidable patient safety risks, which can contribute to serious harm.”

Common issues

The review highlights that EPR systems can improve patient care and support safety, but that there are recurring issues with the design and implementation of the systems that can also create safety risks. Common issues include poor usability and interoperability between EPR systems and other software, outdated hardware and infrastructure affecting system performance, and limited resources to support the safe ongoing use of EPR systems.

The first typical issue is that EPR systems have been chosen without the functions an organisation needs, or do not support the user, either patients or staff.

Then, there is variation in governance processes for implementing EPR systems at national, regional and organisational levels. This means associated risks to patient safety have not always been identified and mitigated.

Third, staff reported limited routes for raising concerns about poor functionality and usability of EPR systems, and limited action when concerns were reported that could impact patient safety.

“Ultimately, this review is clear that effective, needs-led implementation is essential to ensure EPRs have a positive impact on safety – this will help close the gap between digital ambitions and the realities of frontline care,” said Woodier.