Analyzing Health Information Technology and Electronic Medical Record System-Related Patient Safety Incidents Using Data from the Korea Patient Safety Reporting and Learning System

Cho, Dan Bi; Lee, Yu-Ra; Lee, Won; Lee, Eu Sun; Lee, Jae-Ho

doi:2021.27.2.57

Qual Improv Health Care > Volume 27(2); 2021 > Article

Original Article

Quality Improvement in Health Care 2021;27(2): 57-72.
DOI: https://doi.org/10.14371/QIH.2021.27.2.57 Published online December 31, 2021.

환자안전보고학습시스템 자료를 활용한 의료정보기술 및 전자의무기록시스템 관련 환자안전사건 분석

조단비¹, 이유라², 이원³, 이의선⁴, 이재호^2,5

¹연세대학교 의료법윤리학협동과정
²울산대학교 의과대학 정보의학교실
³중앙대학교 간호학과
⁴울산대학교 의과대학 예방의학교실
⁵울산대학교 의과대학 응급의학교실

Analyzing Health Information Technology and Electronic Medical Record System-Related Patient Safety Incidents Using Data from the Korea Patient Safety Reporting and Learning System

Dan Bi Cho¹, Yu-Ra Lee², Won Lee³, Eu Sun Lee⁴, Jae-Ho Lee^2,5

¹Researcher, Department of Medical Law and Bioethics, Graduate School, Yonsei University, Seoul, Republic of Korea
²Research Associate Professor, Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
³Assistant Professor, Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
⁴Researcher, Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
⁵Professor, Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

Correspondence Jae-Ho Lee ,Tel: +82-2-3010-3350, Fax: +82-2-3010-8126, Email: rufiji@gmail.com

Received: October 28, 2021 Revised: November 18, 2021 Accepted: November 26, 2021

Abstract

Purpose
At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS).
Methods
This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm).
Results
Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable.
Conclusion
This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

Key words Patient safety, Health information technology, Electronic health records, Hospital incident reporting