Abstract
Background The health care field is experiencing widespread electronic health record (EHR) adoption.
New medical professional liability (i.e., malpractice) cases will likely involve the
review of data extracted from EHRs as well as EHR workflows, audit logs, and even
the potential role of the EHR in causing harm.
Objectives Reviewing printed versions of a patient's EHRs can be difficult due to differences
in printed versus on-screen presentations, redundancies, and the way printouts are
often grouped by document or information type rather than chronologically. Simply
recreating an accurate timeline often requires experts with training and experience
in designing, developing, using, and reviewing EHRs and audit logs. Additional expertise
is required if questions arise about data's meaning, completeness, accuracy, and timeliness
or ways that the EHR's user interface or automated clinical decision support tools
may have contributed to alleged events. Such experts often come from the sociotechnical
field of clinical informatics that studies the design, development, implementation,
use, and evaluation of information and communications technology, specifically, EHRs.
Identifying well-qualified EHR experts to aid a legal team is challenging.
Methods Based on literature review and experience reviewing cases, we identified seven criteria
to help in this assessment.
Results The criteria are education in clinical informatics; clinical informatics knowledge;
experience with EHR design, development, implementation, and use; communication skills;
academic publications on clinical informatics; clinical informatics certification;
and membership in informatics-related professional organizations.
Conclusion While none of these criteria are essential, understanding the breadth and depth of
an individual's qualifications in each of these areas can help identify a high-quality,
clinical informatics expert witness.
Keywords
medical informatics - malpractice - expert testimony - electronic health records -
education
