#Ehr transcriptions manual#

These data demonstrate that clinically significant discrepancies for clinic-entered point of care results occurred at a rate of approximately results and they underline the importance of interfacing instruments when feasible.Ĭlinical laboratory information systems, point-of-care testing, medical errors, laboratories, electronic health records BACKGROUND AND INTRODUCTIONĮlectronic interfaces are the safest and most reliable methods for the transfer of data from laboratory instruments to laboratory information systems (LISs) and electronic health records (EHRs).

Staff-entered result flags deviated from the result flag generated in the laboratory information system in 5121 of 6930 (73.9%) pairs. An additional 37 (14.2%) errors were due to inclusion of non-numeric characters. Thirty-seven of the 260 (14.2%) errors were discrepant by more than 20% and included potentially dangerous mistranscriptions.

#Ehr transcriptions manual#

Using a dataset arising from a duplicated workflow that created a set of paired interfaced and manually entered point-of-care glucose measurements, we found that 260 of 6930 (3.7%) manual entries were discrepant from their interfaced result. Many point-of-care laboratory tests are manually entered into the electronic health record by ambulatory clinic staff, but the rate of manual transcription error for this testing is poorly characterized.