Number of People Who Can Screw Up a Patient Chart

Posted on May 9, 2009 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A company called FastComany (most notable for famous Microsoft blogger, Scoble having worked there-Yes, I’m showing my geek) wrote an article a while back on EMR and technologies impact on healthcare. It’s an interesting read since it’s kind of an outsider/tech magazine look at healthcare.

One thing that really struck me in the article was the following quote:

In the meantime, Geisinger continues to compile success stories, including that of CEO Steele, who became patient No. 86 in the ProvenCare CABG program. “I was in and out of the hospital in two-and-a-half days,” he says. Casale, who was Steele’s surgeon, says the case opened his eyes to how complex a routine operation really is: “Two weeks after, the head of our IT group called me and said, ‘Al, I just looked through [Steele’s] chart, and I want to send you a list of everybody that accessed the medical record from the time he was seen in the clinic to two weeks post-op.’ There were 113 people listed — and every one had an appropriate reason to be in that chart. It shocked all of us. We all knew this was a team sport, but to recognize it was that big a team, every one of whom is empowered to screw it up — that makes me toss and turn in my sleep.”

113 people legitimately accessing the patient chart in an EMR. The most apparent item here is that it’s a lot of people that could screw up the patient chart. However, that’s not what interested me. What I find most interesting is that an EMR enables us to know that 113 people accessed the chart and exactly what each one did. Think about a paper chart. Any of those 113 people could have made a change and it would be difficult to know who.