The Chicken or the Egg: Do Electronic Health Records Reduce Malpractice Claims?

Electronic health records (EHRs ) have been touted by believers to be the cure to all clinical evils. They promise to improve communication between clinicians, increase the efficiency of visits, reduce costs,
prevent medication errors, increase care coordination, and do everything short of taking your dog for a walk.

Beginning in 2011, the U.S. government initiated financial incentives to hospitals to promote EHR adoption.

Skeptics bring up the concern that EHRs can make clinicians more likely to commit errors due to poorly designed software, unfamiliarity with new systems, or the hazards of the infamous copy and paste function.

Contrary to these concerns, a Massachusetts study found that physicians who use EHRs may have a lower rate of malpractice claims than those who don't. The researchers surveyed 275 physicians to assess their use of EHRs as well as the number of lawsuits filed against them. Malpractice claims for physicians who used EHRs were a sixth of those for physicians who did not use EHRs. Using an EHR was associated with an 84 percent lower chance of getting sued.

This leads to the question of the chicken or the egg. Are physicians who are late adopters of EHRs have particular practice patterns or characteristics that may make them more likely to be sued?

An article in Health Affairs found that physicians in non-primary care specialties and smaller practices, as well as those over 55 years of age lagged in adopting EHRs. Other studies support this finding and have identified physician characteristics associated with early adoption of EHRs. Younger physicians, those working in group and single-specialty practices, and those providing more preventive and chronic disease management services are more likely to adopt EHRs earlier.

- Ulfat Shaikh