Despite more than $30 billion of federal investment in health information technology over the past decade, the transition from paper to electronic health records has not reached its potential to enhance health care coordination and improve patient safety.

The inability of electronic health care record systems to easily share information with each other—known as interoperability—frustrates caregivers and their patients and raises serious safety concerns. Patients still tote their records and prescription bottles from a primary doctor’s office to specialists, and doctors still rely on patients’ memories for critical aspects of their health history. Better interoperability requires a nationwide approach to match patients to their records among the various doctor’s offices, hospitals, and specialists who care for them. It also requires better use of standards and reforms to the ways that electronic health records log data.

Along with interoperability challenges, the varied formats and designs of electronic health records—as well as the ways hospitals and other care settings implement those systems, and how clinicians use them—can introduce unintentional safety problems. The lack of intuitive, easy-to-use interfaces—known as usability—can lead to data entry mistakes, such as recording the wrong patient, the wrong drug, or the wrong dosage. Doctors, hospitals, electronic health record vendors, and policymakers all have a role in identifying and addressing these usability challenges to advance the safety of health information technology.

Pew is conducting research to further quantify and illuminate these problems, and is convening stakeholder organizations to look for and advance solutions. Ultimately, Pew’s work will help realize the vision of health information technology, one where patients’ health information is accessible to them and their doctors, and the format of electronic health records does not raise the opportunity for unintended harm.

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