JAMA Report Calls on EHR Vendors to Do Annual Safety Self-Assessments
By Mike Miliard
The Centers for Medicare and Medicaid Services (CMS) recently updated its Medicare Promoting Interoperability Program to include a new measure mandating that eligible hospitals confirm they have completed an annual self-assessment of their electronic health records (EHRs) using the SAFER Guides from the Office of the National Coordinator for Health IT (ONC). However, a "shared responsibility" for EHR safety will require further steps, assert patient safety researchers. In a commentary in the Journal of the American Medical Association, Dean F. Sittig of University of Texas Health Science Center and Dr. Hardeep Singh of Baylor College of Medicine note "additional steps are required to strengthen the effects of these rules." Hospitals will need to work with their EHR vendors, as several SAFER recommendations rely on EHR features that developers must provide. "For example, one recommendation states, 'Information required to accurately identify the patient is clearly displayed on all portions of the EHR user interface, wristbands, and printouts,'" they authors write. "The hospital cannot comply with that recommendation if the developer has not implemented the feature(s)." Other key strategies include EHR developers self-assessing their IT products annually for safety, ONC performing yearly reviews of SAFER recommendations, and vendors offering clear guidance on how they address safety practices. Sittig and Singh also recommend that CMS add annual SAFER assessment by EHR developers to Promoting Interoperability Program criteria, while EHR developers should have product default settings conform to SAFER guidance. "The annual EHR developer assessment process should be transparent and carried out by teams consisting of EHR designers, developers, implementers and trainers," the authors write, adding that ONC should convene annual expert panels to review the results of developer nonconformity reports and make any needed revisions to the SAFER Guides. The guides, first published in 2014, recommend sets of best practices to help hospitals optimize EHRs and clinical workflows for patient safety. "The new CMS policy requiring hospitals to perform annual self-assessment using the SAFER Guides creates a solid foundation for a much-needed focus on EHR-related patient safety. However, the responsibility for safety must be shared with EHR developers, who should also self-assess their products on an annual basis," conclude Sittig and Singh.
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