Although it’s been four years, the death of Diane Stewart following an elective surgery continues to fuel the discussion of tracking changes within electronic health records (EHRs) in California. Some providers, however, believe there are higher stakes on the table.
Stewart died of a bowel obstruction after knee replacement surgery at Stanford University Medical Center. Portions of her computerized medical record had been deleted after her death, according to a 2008 investigation by the state Department of Public Health.
Stewart’s death, viewed by patient safety advocates as the result of a medical error, is the catalyst for supporters of a bill moving through the California legislature. It would mandate that any change or deletion of electronically stored medical information — including the identity of who made the alteration — is automatically documented.
Some providers are skeptical of this technology because there are larger components of EHR implementation that should take priority, and they also question the overall importance of such a reporting trail.
“Implementing a rule requiring this level of auditing would be expensive and of questionable value,” said Dr. Robert Murry, medical director of informatics at Hunterdon Medical Center in Flemington, N.J. “We need to spend resources making HIT systems easy to use and to interface with each other, not making more audit trails.”
Dr. Emily Patterson, assistant professor at the Ohio State University College of Medicine agreed. “It is my belief that this legislation is unnecessary and a distraction from real issues with safety and effectively providing patient care with software that is quickly gaining in maturity.”
The California Hospital Association (CHA) believes that although EHRs pose new challenges to documentation, hospitals are primarily focused on health information exchange and demonstrating meaningful use, according to a letter to Sen. Mark Leno (D-Calif.). As a result, it brings up the question of what hospitals should be spending their money on in terms of EHRs.
Currently, providers are not required to document any changes to medical records. Nonetheless, the bill is certainly something to keep an eye out for.