Electronic patient record systems: Putting patient safety at the heart of implementation (Patient Safety Learning, 31 July 2024)

Summary

Electronic patient record (EPR) systems have the potential to improve patient treatment, increase efficiency and reduce the costs of healthcare. However, it has become increasingly evident that introducing EPR systems comes with serious patient safety risks.

In a new report, Electronic patient record systems: Putting patient safety at the heart of implementation, Patient Safety Learning looks at this in depth. Drawing on a recent roundtable event, we consider how patient safety can, and must, be put firmly at the heart of the design, development and rollout of EPR systems.

This blog gives a summary of the report and the 10 principles it sets out for safe EPR system implementations.

Content

What is an electronic patient record, or EPR?

An electronic patient record (EPR) is a set of electronic information about a single patient. It can include:

• a patients’ own notes
• test results
• observations by a range of different clinicians
• prescribed medications.

EPR systems are a way of managing clinical information with the intention of making more easily accessible to both patients and healthcare professionals.

EPR systems are increasingly becoming commonplace in healthcare settings across the world and are a core part of how patient care is delivered. They can vary significantly in size and scope. They can exist within a GP’s surgery, focus on a single specialty area, or cover multiple areas within an NHS Trust that serves hundreds of thousands of patients.

EPR systems and patient safety

When safely implemented, EPR systems can help to support and improve care and treatment. However, there are also significant patient safety risks associated with their implementation and use.

On Wednesday 26 June 2024, Patient Safety Learning held a virtual roundtable session with a select group of experts to discuss patient safety risks and avoidable harm associated with EPR systems. We encouraged participants to reflect on the scale of this issue, what was currently going wrong, and what was going well. We asked for their views on the key patient safety risks and how organisations can be supported to implement new EPR systems safely.

Our new report, Electronic patient record systems: Putting patient safety at the heart of implementation, draws on the findings of this roundtable. In the report, we set out the emerging patient safety concerns relating to the implementation of these systems in the NHS. We also reflect on the patient safety issues discussed at the roundtable, grouping these into four main areas:

• planning an EPR programme
• implementing an EPR programme
• safety in use
• incident reporting.

To fully realise the benefits of EPR systems, we need to ensure patient safety considerations are at the heart of their design, development and rollout.

Commenting on the report, Patient Safety Learning Chief Executive Helen Hughes said:

“EPR systems have significant potential to improve patient care and treatment. However, we are increasingly seeing cases where poor implementation of these new systems results in direct and indirect harm to patients. If we are to fully realise their benefits, patient safety must be at the heart of their design, development and rollout.

To ensure the safety of EPR systems, it is vital that patient safety incidents associated with them are reported and acted upon. We need more transparency in reporting and sharing knowledge, of both errors and examples of good practice.

We hope that this report can kick off an informed and transparent debate about these issues, leading to action that supports the safer implementation of EPR systems and reduces avoidable harm.”

Next steps

At Patient Safety Learning we will continue to make the case that patient safety considerations should be at the core of the design, development and rollout of new EPR systems. As part of this work, we will be taking the following steps:

• Sharing this report with NHS England, Integrated Care Board and NHS Trust leaders, EPR vendors, NHS Providers and other stakeholders.
• Exploring the potential for further engagement opportunities including roundtable meetings with representatives from the groups mentioned in the principles. We want to help people take forward the issues and principles identified in the report.
• Capturing further insights on EPR implementations and patient safety from staff and patients on the hub, our award-winning platform to share learning for patient safety.
• Informing patient safety leaders of the issues and principles identified in the report, including through the patient safety networks we support.

Share your experiences and views with us

Are you a patient who has had a positive or negative experienced related to the use of an EPR system? Or a healthcare professional or supplier with experience of implementing a new EPR system?

We would welcome your feedback on the issues raised in the report and are keen to hear further insights from those involved in EPR systems.

You can comment below (sign up to the hub first, for free) or email the team directly at [email protected] to share your experience.

Related content

• Electronic patient record systems: Putting patient safety at the heart of implementation (Patient Safety Learning, 31 July 2024)
• NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn? (Clive Flashman, 10 January 2024)
• The digitalising of patient records — why patients MUST be involved (Anonymous, 16 April 2024)