Becker's Hospital Review

63 CIO / HEALTH IT Viewpoint: 4 ways the EMR is an ethical disaster By Julie Spitzer E MRs are an expensive clerical burden that haven't fulfilled their promise to use meaningful data to inform better patient care, and EMR vendors have profited at the expense of the physician-patient relation- ship, Jamie Wells, MD, wrote in an op-ed for the American Council on Science and Health. "At their best, they added another layer be- tween physician and patient further eroding the relationship and at their worst, they were borderline negligent contributing to a prema- ture exodus of seasoned professionals who had more to give patients and those who came aer them professionally," Dr. Wells wrote. "Which brings me to my main concern of whether or not such forced implementation of EMRs, considered by some as coercive, vi- olated the basic tenets of bioethics." Here are four ways Dr. Wells argues the EMR creates an ethical disaster. 1. Respect for autonomy. Neither physi- cians nor patients were asked about the use of EMRs — the mandate was simply institut- ed. is means patients were never informed about the risks and benefits associated with using EMR data to inform care plans, nor were they warned the tech could take away from the face- to-face time with their physi- cians. 2. Justice. Dr. Wells argues penalizing physi- cians — many of whom did not grow up with technology and don't know how to use it — is unfair as it led to early retirements. e EMR, which prompts physicians to ask questions that may not relate to the patient, forces the patient to have less control over their care. "In addition, preoccupying their doctor with unnecessary extra steps can slow down a pa- tient's getting relief from their suffering. is is not fair to individuals seeking or providing care," Dr. Wells wrote. 3. Beneficence. EMRs create unnecessary challenges that affect physicians' from pro- viding the highest quality of care. "Trans- forming their physician into a data entry specialist by consuming their time erodes the doctor-patient relationship, chips away at things like bedside manner and effective communication that all can impede care," Dr. Wells wrote, adding that EMRs keep physicians in the office longer and "excessive training and continued education are invol- untarily required by staff to remain certified on their respective system." 4. Non-maleficence. Because EMR systems are not interoperable, patients deal with de- lays and inconveniences that can infringe on a patient's choice of caregiver. "EMRs rou- tinely exacerbate the difficulty of getting the information," Dr. Wells wrote. n Study: Hospital data breaches tied to thousands of additional patient deaths By Julie Spitzer A researcher at Nashville, Tenn.-based Vanderbilt University Owen Gradu- ate School of Management claims more than 2,100 patient deaths each year can be attributed to hospital data breaches, according to The Wall Street Journal. Sung Choi, PhD, analyzed data from HHS and CMS to compare patient-care metrics at hospitals that have experienced a data breach with those that have not. The study was presented March 22 at a cyberrisk quantification conference hosted by Drexel Uni- versity's LeBow College of Busi- ness in Philadelphia. One of the care metrics Dr. Choi reviewed was the proportion of heart attack patients who die with- in 30 days of being admitted to a hospital. She found the rate of pa- tient deaths increased by 0.23 per- cent one year after a breach and by 0.36 percent two years after a breach. This equates to 2,160 ad- ditional patient deaths per year. "Before a breach, the control group and breached hospitals are similar, then after a breach there appears some change in trend that made the breach hospitals have worse quality," Dr. Choi told WSJ. Dr. Choi explains the damage caused by a data breach not only diverts funds away from patient care but distracts physicians for years after the incident. "A breach triggers remediation activities, regulatory inquiries and litigation in the years following a breach… [these activities] disrupt and delay hospital services, and therefore leads to care quality problems," she told WSJ. Hospitals that experienced a breach also took more time to ad- minister an electrocardiograph to newly admitted patients — a com- mon way to measure patient care quality — Dr. Choi added. n Allina Health restores computer network after outage affects all 14 hospitals in the system By Julie Spitzer M inneapolis-based Allina Health was back online April 5 after it ost access to its computer network in an outage that began April 4. Patient care has not been affected, according to Fox 9. The health system's computer network suffered a major disruption around 6:30 p.m. April 4; however, by 2 a.m. April 5, the problem had been resolved. All 14 of the system's hospitals — located in Wiscon- sin and Minnesota — were affected by the outage, which led staff to operate under "standard offline procedures," a spokes- person told Fox 9 April 4. Allina hospitals remained open and accepted patients during the downtime. "All systems are now operational. During the outage, Allina Health implemented our standard offline procedures, and there was no impact to patient care, " a hospital spokesperson told Becker's Hospital Review. n

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