The US government has created a set of guides and tools to help health care providers more safely use electronic health records (EHRs). The Safety Assurance Factors for EHR Resilience (SAFER) Guides — which include self-assessment checklists, practice worksheets and recommended practices — were released by the US Department of Health and Human Services on Jan. 15.
“With the release of these guides, stakeholders now have ready access to additional evidence-based knowledge and practical tools to optimize EHR safety,” Dr. Jon White, director of the Health Information Technology Portfolio for the Agency for Healthcare Research and Quality, said in a press release. “Consistent with the Health IT Safety Plan, health care providers and those who support them will use these guides to develop a culture of safety, shared responsibility, and continuous improvement around health IT.”
Nine areas are addressed by the SAFER Guides, including organizational responsibilities, patient identification, clinical communication, test results review and follow-up, system configuration and contingency planning.
A contingency plan is necessary when an EHR system has an unexpected shutdown, which could be due to software failure, hardware malfunction, power outage or any number of unplanned events. Many problems and delays can arise when electronic records become unavailable, says Dean Sittig, a professor in the School of Biomedical Informatics at the University of Texas Health Science Center at Houston.
It can become difficult to register patients, obtain test results from labs, communicate between departments and bill for medical services, to name but a few common problems. And not all hospitals are adequately prepared to function well during an outage.
“The hospitals where there have been downtimes in the past fare better than those that haven’t,” says Sittig. “For some reason, people don’t want to learn this lesson when it happens to their neighbours.”
To prevent EHR downtimes, health care providers should duplicate all critical hardware, have generators support their electronic systems during power outages and implement comprehensive testing and monitoring strategies. If a shutdown still occurs, there should be paper forms available, polices in place to ensure accurate patient identification and a communication strategy that doesn’t rely on an electronic system.
“The recommended practices in the SAFER Guides are intended to be useful for all EHR users, developers, patient safety organizations and others who are concerned with optimizing the safe use of Health IT,” states the guides’ website.