1. Communication in Intensive Care using EHR- A two edged sword
Often medical errors have elements of miscommunication.
Hospitals that communicate poorly will not find an improvement in communication with the introduction of EHRs.
Often the issues get worse!!

2. The promise and pitfalls of EHR
Improves access to clinical information
Accessing medical records remotely can hamper communication
Clinical notification/ Alerts
Notification/ Alert fatigue
How do I respond to an alert?
Unifies clinical data into one system
Potential to improve synthesis of clinical information
Large EHRs can create information silos
Various clinical specialities value and use information differently

3. The promise and pitfalls of EHR
Improves legibility
Improved legibility does not improve readability
Information overload- Charting by exception
Inaccurate information- Cut and paste capabilities
Checklists/ Flowsheets

4. Maximizing promise, minimising pitfalls
EHR cannot replace the adequate clinical communication
Communication vs Documentation
Managing uncertainty
Increased verbal communication crucial when EHR introduced
Overdependence on EHR generated alerts decreases vigilance
“If the software hasn’t alerted me it must be alright”
Software algorithms- every rule has many exceptions
EHR reduces some errors but new errors added
Ability to do a task in different ways
Not necessarily a benefit- Missed information
Early standardisation of workflows
Early standardisation of documents