Healthcare experts propose policies to encourage shared responsibility between developers and users of electronic health records


Newswise – Developers of electronic health records (EHRs) should create or modify their products to ensure that healthcare organizations can meet the safety recommendations of the Safety Assurance Factors for EHR Resilience (SAFER) guides, researchers say from the University of Texas Health Sciences Center. in Houston (UTHealth) and at Baylor College of Medicine.

The document titled “Policies to Promote Shared Responsibility for Safer Electronic Health Records” was released today in the Journal of the American Medical Association (JAMA).

SAFER Guides are a comprehensive collection of safety practices organized in checklist form and designed to help healthcare organizations and EHR developers perform self-assessments of their EHRs. Their goal is to proactively optimize the safety and safe use of EHRs. The guides are sponsored by the Office of the National Coordinator of Health Information Technology (ONC) within the Department of Health and Social Services.

“Earlier this year, the Centers for Medicare & Medicaid Services (CMS) released new payment rules that required all eligible hospitals to use SAFER guides,” said Dean Sittig, PhD, professor of biomedical informatics at the ‘UTHealth School of Biomedical Informatics and co-author on the paper. “What this new rule did not do was force DSE developers to use SAFER guides. We therefore recommend that EHR system developers also evaluate their products annually. This will ensure that their clients can implement and use the EHR as recommended in the SAFER guides.

“We view the new CMS rules as a historic development in EHR safety that impacts all hospitals in the United States,” said Hardeep Singh, MD, MPH, paper co-author, professor of medicine at Baylor and researcher at the Center for Innovations in Quality, Efficiency and Safety (IQuESt) and Michael E. DeBakey VA Medical Center. “But for hospitals to achieve the quality and safety improvements promised by advanced EHRs, we also need to involve DSE developers in the implementation of security practices.

While the new CMS policy requiring hospitals to perform annual self-assessment using SAFER guides creates a solid foundation, the authors say that responsibility for safety should be shared with EHR developers.

Sittig and Singh recommend three specific strategies to complement the new CMS rules. They propose:

  • EHR developers self-assess their products annually against SAFER recommendations and indicate whether their EHR can be configured to meet each SAFER recommendation.
  • ONC should perform annual reviews of SAFER recommendations to track EHR design, development and configuration changes.
  • EHR developers should disseminate guidance to their customers on how to implement security practices related to their product.

They say these strategies strengthen the strong foundation for EHR security laid by new CMS regulations and more evenly divide the responsibility for making security improvements between those who design and develop EHRs and those who configure, implement. and use these systems.

“Some EHRs have already used the SAFER guides to evaluate their products and develop advice for their client,” Sittig said. “The vast majority of the time the EHR works well. No one expects the computer or the use of the computer to lead to an error, but when it does, it can cause great harm to the patient. Collaborative use of SAFER guides can avoid such problems.

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