With few hospitals using SAFER Guides, experts call for regulators to improve focus on EHR patient safety

Concerns about EHR patient safety have grown, but few hospitals are using federally sponsored guidelines.

More than three years after the Office of the National Coordinator for Health IT released EHR safety guidelines, few healthcare organizations have used the resource to address IT-specific patient safety concerns. Regulators might be the one to move the needle. 

ONC released the SAFER Guides (Safety Assurance Factors for EHR Resilience) in January 2014, and they have undergone several updates in the past several years. But competing IT priorities, the absence of safety-related measurements for EHRs and a lack of incentives to use the guides have limited widespread adoption, two experts involved with the creation of the SAFER Guides wrote in an article for The Joint Commission Journal on Quality and Patient Safety.

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Dean Sittig, Ph.D., with the University of Texas' Memorial Hermann Center for Healthcare Quality and Safety and Hardeep Singh, M.D., chief of the health policy, quality and informatics program at the VA Center for Innovations in Quality Effectiveness and Safety, argued that The Joint Commission or the Centers for Medicare and Medicaid Services should consider incorporating basic EHR safety issues into accreditation surveys and payment regulations.

“Patient safety professionals could play key roles here, including championing the implementation of SAFER recommendations,” the authors wrote. “New policy initiatives are also needed to incentivize health care organizations and EHR developers to make these safety assessments on a regular basis.”

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The authors also reaffirmed some of the most valuable portions of the SAFER Guides, urging providers to take a “sociotechnical approach” that blends workflow alterations with technical upgrades, and allowing IT departments to work closely with patient safety leadership to proactively address safety concerns.

EHR management was the foremost patient safety concern facing hospitals in 2017, according to the ECRI Institute, which created a dedicated program for health IT patient safety. Informatics researchers, including Singh, have advocated for the use of daily safety huddles that include IT professionals that can address EHR-related issues.