NAMCS Physician Reported Impact of EHR on Patient Safety

At the end of each day, every physician asks themselves two questions:

• “Was there something I did today that I shouldn’t have?”
• “Is there something I didn’t do that I should have?”

We can now see from the 2013 National Ambulatory Medical Care Physician Workflow Survey (NAMCS) that the answers to those questions weigh lighter on the minds of practicing physicians who have the help of electronic health records (EHR).

Through this annual survey of 11,000 physicians we get a snapshot of how EHR adoption has improved the safety and quality of their office-based care.  The details of the survey are published in an ONC data brief; and the larger contours of the perceived impact of electronic health records are clear: physicians feel that EHRs improve the quality and safety of the care they deliver.  From these data we can see that about 70 percent of physicians answering the survey felt that their EHR helped by alerting them of an important medication or a laboratory test result.

EHRs improve communications

As the practice of medicine becomes more complex, practice tools should help providers manage that complexity. The NAMCS survey finds that electronic health records are helping to improve communication between physicians and members of their care teams.  Nearly 60 percent of physicians using EHRs reported that their system facilitated communication among the care team and roughly one-half of them found that it improved the management of referrals.

Not unexpectedly, physicians in large practices (11 physicians or more) experienced slightly greater improvement in communication across the care team, compared to those in solo practices.

However, no practice tool is a panacea, and when looking at electronic records we also see that 40 percent of physicians felt the EHR led to a less effective communication with their patients during a visit, 15 percent felt the EHR led to an error in ordering a medication or test, and about 15 percent identified too many alerts as the reason they overlooked something important.

EHRs can improve patient safety

The net result of how physicians perceive the effects of electronic records on crucial processes of care within their practice is overwhelmingly positive.  This fact provides us with the support we need as we work toward the two goals of health IT safety articulated in the ONC Patient Safety Action and Surveillance Plan: to improve the safe use of health IT and to improve the overall safety and quality of care delivered through the use of health IT.

Those of us who have worked in any of the domains of safety — health care patient safety, nuclear safety, or aerospace safety — know safety is a journey and not a destination.

This NAMCS survey shows that electronic health records are tools that make the path toward patient safety easier for all of us who, after the day’s journey, soberly reflect on the answers to two very important questions: “Was there something I did today that I shouldn’t have?” and “Is there something I didn’t do that I should have?”

We all share a responsibility to try to answer these questions better today than we did yesterday.  And the good news is that we can meet that responsibility with confidence whether ordering medications and labs, communicating with our colleagues, or remembering important aspects of care, as the EHR is helping us to make that care better.