Study Finds Inaccuracies in Electronic Health Records for Ophthalmic Medications

Medication lists generated from electronic health records (EHRs) may not capture up-to-date and accurate information on ophthalmic medications, according to a new study published in JAMA Ophthalmology.
EHRs are one example of how technology can improve patient care through data capture, but the study highlights the shortcomings of using EHR medication lists. 
For the study, the researchers examined medication-related information contained in the EHRs of 53 patients treated for microbial keratitis, or corneal infection, between July 2015 and August 2018. They compared documentation of medications between the structured medication list extracted from the EHR server and medications written into the clinical progress note and transcribed by the study team.
Of the 247 medications identified, 32.1% differed between the progress notes and the formal EHR-based medication list, according to the study. Additionally, nearly one-third of patients were found to have at least 1 medication mismatch in their record.
In corneal infections, many medications are typically used and treatments can change rapidly, with some drugs requiring compounding.
“Because of the multiple clinic visits and frequent medication changes, it is imperative to have strong verbal and written communication between providers and patients who are battling corneal infections,” lead author and cornea specialist Maria Woodward, MS, MD, assistant professor of ophthalmology, said in a press release.
Patients often receive a medication list generated from the EHR as part of a printed post-visit summary following a medical appointment. The summary should confirm how the provider intends the medications to be used, according to the researchers. However, discrepancy between the clinician’s notes and those on the medication list can result in avoidable medication errors for patients who rely on the automatically generated lists.
“Issues arise when a medication is started by an outside provider and continued at a new hospital and when patients require compounded medications that must be telephoned in to a pharmacist in the evening,” Woodward said.
The findings indicate that these discrepancies can affect patient safety and continuity of care, suggesting that EHR data should be checked for internal consistency before use in research, the study authors concluded.
Woodward M, Ashfaq HA, Lester CA, et al. Medication accuracy in electronic health records for microbial keratitis. JAMA Ophthalmology. 2019. Doi: 10.1001/jamaophthalmol.2019.1444
Study Finds Accuracy Gap in EHRs for Eye Care Patients [news release]. Accessed June 20, 2019.

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