EHR safety guides meant for 'all' providers

Providers of all types and sizes should work to reduce the threat of patient harm when electronic health records are used, and learn to apply best practices by relying on the Office of the National Coordinator for Health IT's new SAFER guides, according to several developers of the guides, speaking on a webinar produced by ONC on Jan. 30.

"The more health IT you have, the more you need these guides," Dean Sittig, Ph.D., a biomedical informatics professor at the University of Texas Health Science Center at Houston and co-author of the guides, said.

The nine SAFER guides, which took two years to create, work as self-assessment tools; each guide includes 10 to 25 "recommended practices" with checklists to tell providers what to do to optimize the safety and safe use of EHRs. The provider determines if a recommended practice is "fully implemented," "partially implemented" or "not implemented."

The guides also include planning worksheets to help providers set goals and track their progress; explain why each recommended practice was important; provide examples to operationalize them; and additional resources, such as HIPAA and Meaningful Use, added Hardeep Singh, a patient safety researcher at the Center for Innovations in Quality, Effectiveness and Safety based at the Michael E. DeBakey Veterans Affairs Medical Center.

Each checklist can be completed in about 20 to 40 minutes, noted Joan Ash, Ph.D., a professor in informatics at Oregon Health & Science University. Planning or instituting changes, she said, would take much longer.

The speakers recommended that providers begin their self-assessments with the "high-priority practices guide," which identifies the high-risk areas and high-priority safety practices. They also recommended that providers use a multi-disciplinary safety team and engage people outside the organization, such as EHR developers. Providers and vendors also need to stop blaming each other for EHR-related patient safety issues, they said.

"It's not only about technology. It's also about the ... environment the technology is embedded in," Singh said.

EHR-related patient safety issues have long been recognized as an "unintended consequence" of EHR use. ONC has taken several steps to increase awareness of the issue. The U.S. Department of Health & Human Services also issued a health IT safety action plan to attempt to resolve some of these issues, and the EHR Association released a code of conduct.

To learn more:
- here are the webinar slides (.pdf)