New National Electronic Health Record Safety System Launched

/PRNewswire/ -- A new electronic health record (EHR) safety reporting system was announced today by the iHealth Alliance, a not-for-profit organization composed of medical society and professional liability carrier executives in collaboration with federal agencies and PDR Network. EHRevent.org establishes a national system where physicians and other health care providers can report issues related to the implementation and use of EHRs.

Using a standardized online format, EHRevent will collect reports from physicians and other health care providers who use EHRs and create reports that medical societies, professional liability carriers and government agencies, such as the U.S. Food and Drug Administration (FDA), will use to help educate providers on the potential challenges that EHR systems may bring. The system will be available directly via the Internet at www.EHRevent.org and also integrated into the web sites of participating liability carriers, medical societies, PDR Network and other partners, including EHR system vendors.

EHRevent was modeled after other national reporting systems, including the system used in the aviation industry, and its reports include issues related to software problems, inadequate user training, security breaches and near-misses. Reports will be confidential but used to better understand challenges associated with the adoption and implementation of EHRs and to improve patient safety.

"Electronic health records are being adopted at record rates and present an opportunity to advance patient care," said Nancy Dickey, M.D., iHealth Alliance chair and former president of the American Medical Association. "As with any new system, there is a learning curve for the software providers and for the doctors who use these systems. EHRevent will help us all get smarter about EHRs and assure that patient care advances are also patient-safe advances."

Professional liability carriers who insure doctors against malpractice claims are among the strongest supporters of EHRevent.

"EHRs can impact both the care that is delivered and the record of that care," explained David Troxel, M.D., medical director for The Doctors Company, which is the country's largest professional liability carrier. "EHRs can play a major role in advancing the practice of good medicine, but there are often unanticipated consequences when new technologies are deployed and it is important to collect and disseminate EHR user experience as these powerful systems are adopted."

Alan Lembitz, M.D., vice president of Patient Safety and Risk Management for COPIC Insurance Company, added, "Our experience indicates that EHRs have the capacity either to induce or to reduce medical errors in very unique ways, and we have seen data that indicates that EHR adoption may reduce physician liability. It will be increasingly important to understand best practices to improve patient safety for EHRs and for their users, and EHRevent will help both."

EHRevent is also working directly with EHR vendors as well as Regional Extension Centers (RECs), which are federally designated groups that assist physicians with EHR selection and adoption. Participating EHR vendors and RECs will help educate physicians regarding the importance of EHR event reporting and will receive reports as EHRevent partners.

"Patient safety is at the core of our mission to assist in the adoption of EHRs," explained Kathy Mechler, co-director and chief operating officer for the Texas A&M Health Science Center Rural and Community Health Institute, which includes the CentrEast REC. "We look forward to working with the many EHRevent partners to help educate providers and drive safe EHR adoption."

Michael Stearns, M.D., president and CEO of e-MDs, Inc., a leading EHR vendor, and board president of the Texas e-Health Alliance said, "EHRs have tremendous potential to improve the quality and efficiency of healthcare, but like any tool they must be designed and implemented in a way that uses best practices that strive to eliminate medical errors. We are anxious to collaborate with the EHRevent effort and we encourage all EHR vendors to participate because we believe that EHRevent can be an important communication platform to improve patient safety related not only to EHRs but to medical devices and drugs."

Data collected by EHRevent will also be used by the FDA to help evaluate any safety issues that may arise during the widespread implementation of this technology.

"We applaud the efforts of the iHealth Alliance to help assure the safety of EHRs," said Jeffrey Shuren, M.D., J.D., director of the FDA's Center for Devices and Radiological Health. "We look forward to working with the iHealth Alliance to encourage physicians and EHR vendors to report information on their experiences with electronic health records to EHRevent and other appropriate reporting systems."

EHRevent and a similar service for reporting adverse drug events via EHRs will be governed by the iHealth Alliance, with network operations provided by PDR Network. PDR Network CEO, Edward Fotsch, M.D. explained, "EHRevent, and RxEvent for adverse drug events, will collect information using online forms that include the Common Format developed by the Agency for Healthcare Research and Quality (AHRQ) and will keep the information confidential through PDR Secure, a Patient Safety Organization, allowing only participating organizations to access the reports.

"We know that clinicians and health care organizations want to participate in efforts to improve patient care," said William Munier, M.D. Director for the Center for Quality Improvement and Patient Safety, AHRQ. "Patient Safety Organizations (PSOs) facilitate a shared-learning approach that supports effective interventions to reduce risk of harm to patients and improve quality. We are collaborating in efforts to facilitate reporting to PSOs those adverse events that are related to EHRs and other health information technology, in order to facilitate the development of safer health information technology solutions."

Starting today, U.S. physicians and other healthcare professionals will learn about and be encouraged to use EHRevent by their medical societies, liability carriers, the FDA, PDR Network and other participating groups.

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Online Course Gives Physicians Useful Info about Community-Associated MRSA

A new bacterial infection is running rampant in communities because of antibiotic abuse, but ironically it is often misdiagnosed and treated with the wrong antibiotics, says a physician working to stop it.

Physicians regularly mistake the abscesses, or pockets of pus, caused by community-associated MRSA, or CA-MRSA, for spider bites and treat them as such, say Dr. Jim Wilde, pediatric emergency medicine and infectious disease physician at the Medical College of Georgia.

"Don't be fooled into thinking it's a spider bite," he says. "Think MRSA if you see a sore like that on somebody's hand or arm. The problem is that doctors are choosing the wrong oral antibiotics or are just not recognizing it at all."

Now they can log on to a new online lecture through the MCG Division of Continuing Education to learn more about this leading cause of skin and soft-tissue infections in the state.

It's part of a statewide educational campaign sponsored by Georgia United against Antibiotic Resistant Disease, or GUARD, to raise awareness about CA-MRSA.

Doctors and the general public can access the lecture at www.mcg.edu/ce/Online/mrsaonline. Physicians can receive continuing medical education credits for participating.

"The lecture, which is the first online continuing medical education course at MCG, is an excellent opportunity to learn more about this epidemic," says Caro Cassels, director of the continuing education division.

"There is a lot of misinformation and misunderstanding about MRSA, even among practicing physicians," says Dr. Wilde, who directs GUARD. "And we see dozens of cases of CA-MRSA in the emergency room every week here. It is a different type of MRSA than what we've known for the last 40 years and is spreading all over the country very rapidly."

MRSA, or methicillin resistant Staph aureus, cannot be killed by methicillin, a type of penicillin. It is spread by physical contact, not by breathing the same air or coughing. It lives on the skin and can survive on others surfaces for at least 24 hours. Hospital-associated MRSA (HA-MRSA) has been rampant inside hospitals since the early 1960s but was rare among healthy people in the community. CA-MRSA popped up around 2003 and quickly spread nationwide, causing infections primarily in healthy people outside hospitals. Infections caused by either form of MRSA can be treated, but HA-MRSA is much more dangerous. Both are resistant to all beta-lactam antibiotics, which are the most widely used class of antibiotics available.

"And yet, despite the fact that most skin and soft-tissue infections now are caused by CA-MRSA, there are still many doctors who are prescribing these antibiotics," Dr. Wilde says. "We're trying to do is get the word out to everyone in the state to stop using beta-lactams for skin infections."

In addition to the online course, 9,700 primary care physicians received educational packets from GUARD. Each packet contains a CA-MRSA fact sheet, an informational poster, a two-page synopsis of Centers for Disease Control and Prevention recommendations for treating CA-MRSA and a fill-in-the-blank discharge sheet. Dr. Wilde also coordinates a speakers' bureau on CA-MRSA with more than 30 members available to deliver lectures anywhere in the state.

GUARD is the Georgia chapter of the CDC's Get Smart about Antibiotic Use Program. The coalition seeks to reduce antibiotic-resistant disease by decreasing inappropriate antibiotic use. The educational campaign also is sponsored by the Georgia Department of Human Resources.

For more information about the online course and coalition, visit www.ga-guard.org.

By Amy Connell
Medical College of Georgia

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