Adherence to recommended electronic health record safety practices across eight health care organizations

作者：Sittig Dean F^*; Salimi Mandana; Aiyagari Ranjit; Banas Colin; Clay Brian; Gibson Kathryn A; Goel Ashutosh; Hines Robert; Longhurst Christopher A; Mishra Vimal; Sirajuddin Anwar M; Satterly Tyler; Singh Hardeep

来源：Journal of the American Medical Informatics Association, 2018, 25(7): 913-918.

DOI：10.1093/jamia/ocy033

• electronic health records (EHR)
• patient safety
• risk assessment

Objective: The Safety Assurance Factors for EHR Resilience (SAFER) guides were released in 2014 to help health systems conduct proactive risk assessment of electronic health record (EHR)-safety related policies, processes, procedures, and configurations. The extent to which SAFER recommendations are followed is unknown.
Methods: We conducted risk assessments of 8 organizations of varying size, complexity, EHR, and EHR adoption maturity. Each organization self-assessed adherence to all 140 unique SAFER recommendations contained within 9 guides (range 10-29 recommendations per guide). In each guide, recommendations were organized into 3 broad domains: "safe health IT" (total 45 recommendations); "using health IT safely" (total 80 recommendations); and "monitoring health IT" (total 15 recommendations).
Results: The 8 sites fully implemented 25 of 140 (18%) SAFER recommendations. Mean number of "fully implemented" recommendations per guide ranged from 94% (System Interfaces-18 recommendations) to 63% (Clinical Communication-12 recommendations). Adherence was higher for "safe health IT" domain (82.1%) vs "using health IT safely" (72.5%) and "monitoring health IT" (67.3%).
Conclusions: Despite availability of recommendations on how to improve use of EHRs, most recommendations were not fully implemented. New national policy initiatives are needed to stimulate implementation of these best practices.

• 出版日期2018-7