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. 2018 Jul 1;25(7):913-918.
doi: 10.1093/jamia/ocy033.

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

Dean F Sittig  1 , Mandana Salimi  2 , Ranjit Aiyagari  3 , Colin Banas  4 , Brian Clay  5 , Kathryn A Gibson  6 , Ashutosh Goel  7 , Robert Hines  8 , Christopher A Longhurst  5 , Vimal Mishra  4 , Anwar M Sirajuddin  9 , Tyler Satterly  10   11 , Hardeep Singh  10   11
Affiliations

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

Dean F Sittig et al. J Am Med Inform Assoc. .

Abstract

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.

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Figures

Figure 1
Figure 1
Graph illustrates mean percentage of recommendations for each SAFER guide scored as “Fully implemented” (blue bars) by participating healthcare organizations. Black lines show the range (minimum to maximum score for each guide). Note: SAFER Guide categories (i.e., Foundation, Infrastructure, and Clinical Process) along with the number of recommendations on each SAFER Guide are included in parentheses.
Figure 2
Figure 2
Comparison of “High Priority” SAFER guide implementation status across 8 health care organizations.
Figure 3
Figure 3
Comparison of SAFER guide recommendation implementation status (Fully Implemented) across sites.
See this image and copyright information in PMC

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