Electronic health records and national patient-safety goals

To create a coordinated, consistent, national strategy that will address the safety issues posed by EHRs, we propose that a concerted effort be made to improve health care safety in the context of technology use. This effort should address preventable risks that may hamper endeavors to create a safer EHR-enabled health care system. Further discussion and consensus among national agencies (e.g., the Office of the National Coordinator for Health Information Technology [ONC], the AHRQ, the Joint Commission, the Centers for Medicare and Medicaid Services) is clearly necessary for the adoption of future national patient-safety goals specific to EHR use. However, this approach must be given immediate priority considering the rapid pace of EHR adoption and the resulting changes in our nation's health care system. National EHR-related patient-safety goals are needed to address current problems with existing EHR implementations and failures to leverage current EHR capabilities. For instance, the ONC has recently taken several important steps in this direction with release of the revised 2014 EHR certification criteria (e.g., emphasis on user-centered design and application of quality management systems in the EHR design and development process⁵⁸). Such efforts should be expanded in the future. Goals must be technically feasible, financially prudent, and practically achievable within current constraints and be accompanied by specific guidance on achieving them. Input on these goals must be sought not only from EHR developers and clinical end users but also from cognitive scientists, human-factors engineers, graphic designers, and informaticians with expertise in patient safety in complex health care environments. Creating unique EHR-related national patient-safety goals will provide new momentum for patient-safety initiatives in an EHR-enabled health system.