Becker's Hospital Review

69 CIO / HEALTH IT U of Wisconsin Health CMIO: Copy-and-Pasting in EHRs Is a 'Blot on Our Profession' By Jessica Kim Cohen P roviders must consider patient safety con- cerns associated with the overuse of copy- and-paste functions within EHRs, Shannon M. Dean, MD, chief medical information officer of Madison-based UW Health, wrote in an op-ed for the Agency for Healthcare Research and Quality's Patient Safety Network. A study of 23,630 electronic inpatient progress notes published in the journal JAMA Internal Medi- cine found only 18 percent of notes constituted orig- inal entries by clinicians. irty-six percent of notes were imported from another source, while 46 per- cent were copied-and-pasted from a previous note. e use of copy-and-paste functions in clinical notes raises a few concerns, according to Dr. Dean. For example, it may contribute to a physician creating a "rambling" note about a patient's history instead of focusing on key aspects of his or her current health status. As an example, Dr. Dean cited a 2013 study in JAMA Internal Medicine that determined 35 percent of 190 diagnostic errors in primary care clinics could be attributed to mistakes made while copy-and-pasting within EHRs. "e fact that we continue to use a tool that we ac- knowledge as unsafe without taking real action to improve its use is a blot on our profession," she wrote in her op-ed. To remedy the issue, Dr. Dean suggested healthcare researchers investigate the potential link between copying-and-pasting information and patient safety more rigorously. She also recommended hospitals im- plement review processes to provide feedback to cli- nicians who heavily rely on copy-and-paste functions. As technology evolves, Dr. Dean also noted inno- vations in natural language processing and voice recognition soware may provide other avenues to streamline clinical documentation for providers. "Ultimately, physicians need to reestablish owner- ship of the accuracy of clinical documentation," she wrote. "We must stop blaming the EHR for our care- lessness and start educating ourselves about how to use documentation efficiency tools, including copy and paste, more responsibly." n Microsoft Calls for 'Digital Geneva' in Wake of High Profile Cyberattacks By Julie Spitzer F ollowing a series of high-profile cyberattacks, Microsoft President Brad Smith urged tech firms to work with politicians to reassess regulations and set global norms that would police cyberspace, ac- cording to CNBC. "This is supposed to be a time of peace… so the world has literally, in that regard, been turned upside down from protecting civilians in times of war to attacking civilians in times of peace," Mr. Smith said at the World Economic Forum in Davos, Switzerland, CNBC reported. Mr. Smith is pushing for a new Digital Geneva Convention that would help identify and fill gaps in international regulations related to cyberspace. But, this isn't the first time Mr. Smith has called for global collaboration on this issue. Shortly after the 2016 U.S. presidential election campaign suffered a hack and disclosure of Democratic Party emails, he brought up the idea. n 5.6M Patient Records Breached in 2017: 6 Things to Know By Julie Spitzer N early 5.6 million patient records were breached during 477 inci- dents documented in 2017, up from 450 incidents in 2016 that compromised 27 million patient records, according to a Prote- nus report. The report, part of the "Protenus Breach Barometer" monthly series, an- alyzed healthcare breaches reported to HHS or disclosed to the media throughout the year. Here are six things to know. 1. Nearly 176 incidents were the result of insider error or wrongdoing. Insider-error affected 785,281 patient records and insider-wrongdoing affected 893,978 records. 2. June had the greatest number of breaches disclosed (53) and March had the greatest number of patient records breached (1.4 million). 3. Though there were 58 more hacking incidents in 2017 (178) than in 2016 (120), there was a significant decrease in the number of records that those incidents affected. Hacking incidents accounted for 37 per- cent of all 2017 breaches, compromising 3.4 million records; compared to 2016, which saw 87 percent of breaches from hacking and compro- mised 23.7 million records. "This can be attributed to the lack of the massive hacking incidents like those we reported in 2016," the report stated. 4. The majority of entities reporting data breaches in 2017 were health- care providers (79 percent), health plans (12 percent) and business asso- ciates or vendors (5 percent). 5. It took healthcare organizations an average of 308 days to discover a breach, but only 73 days to report a breach to HHS. 6. While California had the most reported incidents (57), three states did not have any reported breaches: Hawaii, Idaho and New Mexico. n

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