Prevent manual transcription errors in poc testing
When results of point-of-care tests are entered manually by staff into the EHR, it is inevitable that transcription errors are…
When results of point-of-care tests are entered manually by staff into the EHR, it is inevitable that transcription errors are going to sneak in. But how big a problem is this? A study published in the Journal of the American Medical Informatics Association shows a worrying rate of clinically significant errors occur.
Transcription error rate
The researchers wanted to understand the rate of manual transcription error, as this wasn’t well defined in an outpatient clinical care setting, so they studied manually entered glucose measurements. In their study measuring the rate of manual transcription error in outpatient point-of-care testing, they found that 260 of 6930 (3.7%) of manual entries were discrepant. And of those, 37 (14.2%) were so big as to be potentially dangerous — these were results discrepant by more than 20%.
This data shows clinically significant discrepancies occurred at a rate of around 5 per 1000 results.
This is unquestionably a patient safety issue, as it creates a risk of patient harm from providers acting on inaccurate results.
The study used glucose instruments, but in other POC testing instruments such as CBCs, a transcription error could lead to a potentially more severe misdiagnosis.
Patient safety risk
As billions of POC tests are conducted each year and are currently entered into the EHR manually by staff, this problem of transcription error is going to be widespread in ambulatory care. No matter how careful a staff member is, they are always going to make mistakes especially in busy, time-pressured environments. The national patient safety risk this creates is therefore very big.
Removing the human from the process is the solution! A POC testing result interface is the safest and most reliable method to transfer lab results to the EHR. Unfortunately as the authors state, instruments are often not interfaced to the EHR due to technical hurdles and resource limitations with existing middleware and laboratory information systems (LIS). This is exactly why we built Relaymed, to be a simple and affordable solution for the ambulatory market, to interface devices and automatically transfer results to the EHR. This problem of manual transcription error in point-of-care testing does not need to exist!
The value of middleware for interfacing instruments to the EHR often focuses on efficiency gains and the return on investment it can bring clinics when they are considering adoption — but the value it brings to patient safety, as shown by this research, should perhaps give thought for greater emphasis over purely financial benefits.
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