August 13, 2009

Blogging at the Legal EHR Summit in Chicago Next Week

What do e-Iatrogenesis, HIT, CPOE, EHR, and eDiscovery all have in common?  They're just some of the many medicolegal and technological terms and issues being discussed next week at the Legal EHR Summit at the Chicago Marriott Downtown.  The summit is organized by AHIMA, the American Health Information Management Association.

As our nation's healthcare industry becomes even more computerized and integrated, partly due to ARRA (the American Recovery and Reinvestment Act of 2009), the intersection of healthcare, electronic records, records management, and legal issues (including litigation and eDiscovery) will likely explode as well.

I'll be attending and blogging as time and Wi-Fi access permits.  Please feel free to look me up as I enjoy the many opportunities for discussions at these events.  For the uninitiated, I've put together a quick cheat sheet for a few select terms below, along with their sources on the Web for more in-depth definitions:

HIT:  Health Information Technology

Think of HIT as IT for healthcare-related systems, along with ARRA's goal of establishing a nationwide interoperable Health IT infrastructure.

CPOE:  Computerized Physician/Provider Order Entry - An electronic system that healthcare professionals can use to enter drug prescriptions and diagnostic orders, among other things.

EHR (aka Legal EHR):  Electronic Health Record

The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting.

e-Iatrogenesis:  "Patient harm caused at least in part by the application of health information technology."

Think of e-Iatrogenic events as things that can go wrong for patients when CPOE systems are implemented and involved.  For example, consider errors relating to patient drugs or diagnostic tests, including errors of commission or omission.

This succinct discussion of e-Iatrogenesis contains a nice explanation of the types of "unintended adverse events":

These unintended adverse events may fall into technical, human-machine interface or organizational domains.  Some e-iatrogenic events will represent the electronic version of "traditional" errors, such as a patient receiving the wrong drug dosage due to a human click-error.  But other HIT precipitated or enabled errors may have no exact analog in the non-electronic context. For example, a clinical decision support system (CDSS) embedded within an electronic health record might contribute to a clinician's incorrect diagnosis or treatment plan; this could represent either a "type-one" or "two" error (e.g., making a diagnosis that was not present or missing one that was).

Stay tuned for more blog posts on these topics . . . 

Topic(s):   Electronic Discovery
Posted by Jeff Beard