default values impact patient safety

A recent study conducted by the Pennsylvania Patient Safety Authority examined the effects of “default values” in electronic health records (EHRs) and computerized physician order entry (CPOE) systems. Default values are used in EHRs to increase standardization and efficiency, but can cause errors if not utilized correctly. A medication’s dose, route, and administration time are examples of default values.

The study found that out of 1,249 hospital error reports, 324 were related to default EHR values. However, of these 324 errors, 40% were due to user error, such as forgetting to change a default value or failing to enter in an order completely.   

“EHR vendors, like MEDITECH, must provide an easy way to make edits to avoid these types of errors,” says MEDITECH Physician Consultant K. Nadeem Ahmed, MD. “The system must allow for easy editing so the user can easily change the settings. With MEDITECH’s 6.x platform, physicians can easily change a medication dosage directly from the main order set screen.”

Default values can streamline workflow, but attention to detail is still key. “At the end of the day, we physicians are responsible for the orders we place,” adds Dr. Ahmed.

Hospital staff should also be ready to review content provided by their EHR vendor. “Now that we’re delivering content, the local ‘vetting’ of the order sets and dictionaries, especially pharmacy, is crucial,” he states.

Ultimately, ensuring the patient is receiving safe and efficient care should be a shared goal between the hospital, the caregivers, and the EHR system. “If physicians can’t trust their information system, they will not risk their patients’ care by using it,” says Dr. Ahmed. “MEDITECH continues to evaluate and enhance our CPOE solution to ensure the integrity of transmitted physician orders.”