Study: EHRs may lower malpractice settlements
The study was conducted by the department of ambulatory care and prevention at Harvard Medical School and Harvard Pilgrim Health Care in Boston. The researchers examined survey responses from 1,140 practicing physicians in Massachusetts during 2005 concerning their demographic characteristics and the length and extent of their EHR use.
The physicians' malpractice history was accessed using data from the Commonwealth of Massachusetts' Board of Registration in Medicine. The study team compared the presence or absence of malpractice claims among physicians with and without EHRs, including only claims that had been settled and paid.
"There is broad consensus that EHRs are an essential foundation for the delivery of high quality care. As EHR adoption proceeds as a national health policy objective, some have wondered whether EHRs can help to prevent medical malpractice claims," said the study’s senior author Steven Simon, assistant professor at Harvard University in Boston.
Overall, the researchers found that 6.1 percent of physicians with EHRs and 10.8 percent of physicians without them had paid malpractice settlements in the preceding ten years. After controlling for potential confounding variables, there remained a trend favoring EHR use, although the result was not statistically significant.
In a secondary analysis among EHR adopters, the authors found that 5.7 percent of more active users of their systems had paid malpractice settlements, compared with 12.1 percent of less active users. Small numbers of physicians in both groups led the authors to interpret the results with caution.
The investigators speculated that EHRs may decrease paid malpractice claims for a number of reasons. According to the authors, EHRs offer easy access to patients' history, which may result in fewer diagnostic errors, improved follow up of abnormal test results, and better adherence to clinical guidelines. In addition, the clear documentation of care allowed by EHRs can bolster legal defenses if a malpractice claim is filed, they wrote.
“The results of this study indicate that preventing medical malpractice claims may be another compelling reason for physicians, practices and policy makers to forge ahead with efforts toward universal adoption and optimal usage of EHRs,” according to Simon.
The Agency for Healthcare Research and Quality (AHRQ) and the Massachusetts e-Health Collaborative funded the study.