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Title [sv]
Det står fel i min elektroniska journal, vad gör jag nu? Inverkan av journalfel på patienter och vårdpersonal
Title [en]
My Electronic Health Record is wrong, now what? The impact of EHRrors on patients and healthcare professionals
Abstract [sv]
 FrågeställningElektroniska patientjournaler har blivit en central del i patientcentrerad vård i Sverige. Men journaler innehåller ofta fel, ibland kallade journalfel.Journalfel är vanliga och kan handla om allt ifrån felaktigheter till livsviktig, utelämnad information. Enligt några källor har varannan patient hittat ett journalfel, och medan flertalet vårdpersonals (VP)  förväntar sig journalfel, gör patienter det inte. Hittills har forskningen om vilka typer av felaktig journaldata som finns och vilka patientgrupper som är särskilt utsatta för dem endast genomförts i USA. Vi vet därför ännu lite om journalfel i Sverige, samt deras inverkan på patienter och VP. Syftet med projektet är att adressera denna viktiga kunskapslucka med hjälp av fyra forskningsfrågor:Fråga 1. Vilka typer av journalinformation har patienter identifierat som felaktig, inkorrekt eller utelämnad?Fråga 2. Vilken effekt, om någon, har kön, ålder eller diagnos på upptäckt av olika typer av journalfel?Fråga 3. Vilken inverkan, om någon, har journalfel på patienter, med fokus på användning av 1177 Journalen, relationen till VP och vårdupplevelser?Fråga 4. Vilken inverkan, om någon, har journalfel på VP, med fokus på arbetsmiljö, relationen till patienter och oro kring medicinsk-juridiska aspekter?Data och metodTre studier planeras:Studie 1. Analys av redan insamlade data kring journalfel i Sverige.Studie 2. Insamling av exempel på journalfelstyper med hjälp av en nätbaserad enkät, med flernivåmodelleringsanalys utifrån patientrapporterade patientegenskaper och patientrelaterade variabler som extraheras från journalen, för att bedöma vilka faktorer som kan kopplas till en ökad sannolikhet för att hitta journalfel.Studie 3. Fokusgrupper med patienter och VP för att utvärdera den mångfacetterade inverkan av journalfel.Samhällsrelevans och nyttiggörandeProjektet är av hög samhällsrelevans eftersom journalfel utgör en betydande säkerhetsrisk och underminerar VPs arbete med kvalitetssäkring, vilket sannolikt påverkar deras arbetsmiljö negativt. Projektet kommer att samproducera utbildningsmaterial baserat på ett evidensbaserat ramverk för journalfelsklassificering, vilket kommer att bidra till öka allmänhetens medvetenhet kring journalfel, fortsatt utbildning av VP och att informera policy.GenomförandeProjektet kommer att tillämpa ett tvärvetenskapligt tillvägagångssätt, och dra nytta av expertis hos medlemmar i samhället, såsom patienter, VP, samt rådgivare inom industri och forskning.
Abstract [en]
 Research problem and specific questionsElectronic health records (EHRs) have become central to patient-centred healthcare in Sweden. EHRs aid healthcare professionals (HCPs) in patient engagement and empower patients to make informed care decisions. But EHRs are full of errors, or so-called EHRrors.EHRrors can range from inaccuracies to critically omitted information, and they are common. By some estimates, every second patient has found an EHRror, and while many HCPs expect EHRrors, patients likely do not. Research on what types of EHR data is erroneous and which patients are likely to experience them is limited to the US. Little is known about EHRrors in Sweden, as well as about their impact on patients and HCPs. The aim of the project is to address this critical knowledge gap through four research questions (RQs):RQ 1. What types of EHR information have patients identified as incorrect, inaccurate or critically omitted?RQ 2. What is the effect, if any, of gender, age, and diagnoses on the encounter of different EHRror types?RQ 3. What impact, if any, do EHRrors have on patients, focusing on the use of 1177 Journalen, relationship with HCPs, and healthcare experience?RQ 4. What impact, if any, do EHRrors have on HCPs, focusing on work environment, relationship with patients, and medicolegal concerns?Data and methodThree studies are planned:Study 1. Analysis of existing data on EHRrors in SwedenStudy 2. Collection of EHRrors types examples through an online survey, and multilevel modelling analysis of the patient-reported and EHR-extracted characteristics to determine factors associated with increased likelihood of EHRror encounter.Study 3. Focus groups with patients and HCPs to determine the multifaceted impact of EHRrors.Societal relevance and utilisationThe project is of high societal relevance as EHRrors pose a significant patient-safety risk due to undermining the quality assurance work of HCPs and likely negatively affect their work environment. The project will co-produce educational materials (EHRrors Databank and EHRrors Case Vignettes) based on an evidence-driven EHRrors Classification Framework, which will contribute to public awareness, continued training of HCPs, and inform policy update.Plan for project realisationThe project will employ an interdisciplinary approach, soliciting the expertise of the members of the wider community including patients, clinicians, industry and research advisors. 
Publications (1 of 1) Show all publications
Kharko, A., Hägglund, M., Angelova, D., Scott Duncan, T., Hagström, J., Hansford, K., . . . Blease, C. (2025). Prevalence and types of errors in the electronic health record: protocol for a mixed systematic review. BMJ Open, 15(6)
Open this publication in new window or tab >>Prevalence and types of errors in the electronic health record: protocol for a mixed systematic review
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2025 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 15, no 6Article in journal (Refereed) Published
Abstract [en]

Introduction In countries with access to the electronic health record (EHR), both patients and healthcare professionals have reported finding errors in the EHR, so-called EHRrors. These can range from simple typos to more serious cases of missing or incorrect health information. Despite their potential detrimental effect, the evidence on EHRrors has not been systematically analysed. It is unknown how common EHRrors are or how they impact patients and healthcare professionals.Methods and analysis A mixed systematic review will be carried out to address the research gap. We will search PubMed, Web of Science and CINAHL for studies published since 2000, which report original research data on patient-identified and healthcare professional-identified EHRrors. We will analyse (1) the prevalence of EHRrors, (2) the types of EHRrors and (3) their impact on care. Quantitative and qualitative findings will be synthesised following the Joanna Briggs Institute Framework for Mixed Systematic Reviews. Identified studies will be critically appraised for meta-biases and risk of bias in individual studies. The confidence in the emerging evidence will be further assessed through the Grading of Recommendations Assessment, Development and Evaluation approach. Findings will be contextualised and interpreted involving an international team of patient representatives and practising healthcare professionals.Ethics and dissemination The study will not involve collection or analysis of individual patient data; thus, ethical approval is not required. Results will be published in a peer-reviewed publication and further disseminated through scientific events and educational materials.PROSPERO registration number CRD42024622849.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2025
National Category
Other Medical Sciences
Identifiers
urn:nbn:se:uu:diva-558873 (URN)10.1136/bmjopen-2024-098241 (DOI)001505404300001 ()40490366 (PubMedID)2-s2.0-105008083229 (Scopus ID)
Funder
Swedish Research Council, 2022-01020Forte, Swedish Research Council for Health, Working Life and Welfare, 2024-01288
Available from: 2025-06-10 Created: 2025-06-10 Last updated: 2026-07-03Bibliographically approved
Principal InvestigatorKharko, Anna
Coordinating organisation
Uppsala University
Funder
Period
2025-01-01 - 2027-12-31
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
DiVA, id: project:9135Project, id: 2024-01288_Forte