An Issues Log is a tool for identifying emergent unintended consequences of electronic health record (EHR) implementation. You should record any problems that arise during EHR implementation in your Issues Log. In addition, be sure to include reports of more subtle issues that could conceivably lead to problems in the future. By recording issues in your Issues Log, you can track problems from discovery to remediation. Your Issues Log will help you address any EHR implementation issues that could be hazardous in the future before they become serious problems. Issue Logs serve as a reminder to everyone in your practice/hospital/health center of the EHR implementation issues that should be resolved. In addition, an Issues Log will help your practice/hospital/health center plan for and prioritize future quality improvement efforts.
What information is collected in the log?
The Issues Log should include a detailed description of the issue as well as information about potential risks that the issue poses or incidents that have occurred as a result of the issue.
Who maintains the log?
You should make sure the designated person has the authority to act on the information. This might be a vice president of the hospital, an associate chief medical officer, the office manager at a medical practice, the chief quality officer, the risk management department, or others.
Who reports problems to the log?
Encourage all end users (clinicians, nurses, pharmacists, technicians) and IT staff to report problems encountered when setting up or using the EHR. Remember, all problems — even problems that are clearly "user errors" — have consequences. An unreported issue could result in a patient safety concern.
How is information collected for the log?
Depending on the size of your organization, you can collect issue reports through face-to-face conversations, anonymous suggestion boxes, dedicated help desks, and/or anonymous web-based reporting systems.
Issues Log Template
The Issues Log Template [XLS - 31 KB] serves as a basic example of what an Issues Log might look like. You can adapt and modify the template to meet the needs of your organization’s specifications.
For More Information
For more information about Issues Logs, please see the Guide to Reducing Unintended Consequences of Electronic Health Records.
- Prepared by RAND Corporation under Contract No. HHSA290200600017I, Task Order #5. Agency for Healthcare Research and Quality (AHRQ). "Guide to Reducing Unintended Consequences of Electronic Health Records."