Study to build self-assessment tools to prevent EHR-related errors
While much talk centers on the promise of EHRs to improve healthcare quality and safety, a recent study brings to light unexpected EHR-related errors and efforts to develop self-assessment tools to prevent them.
Safety Assurance Factors for EHR Resilience (SAFER) study protocol, published on April 12 in BMC Medical Informatics and Decision Making, outlined steps its researchers will follow to develop, implement and test self-assessment guides. The guides will be used by clinicians and healthcare organizations at selected sites with EHR-enabled systems and include subsequent on-site evaluations, according to author Hardeep Singh, MD, chief of the Health Policy and Quality Program at the Houston VA Health Services Research and Development Center of Excellence, and colleagues.
“The health IT patient safety assessment guides might lead institutions to better leverage the benefits of EHRs,” Singh et al wrote. “Using a multi-faceted, crossdisciplinary approach to develop evidence-based guidance for the EHR-enabled work system might be a useful step in improving patient safety in technology-enabled healthcare.”
These guides will focus on nine identified risk areas: (1) computerized provider order entry and e-prescribing; (2) clinical decision support; (3) test result reporting; (4) communication between providers; (5) patient identification; (6) EHR downtime events; (7) EHR customization and configuration; (8) system-system interface data transfer; and (9) health IT safety-related human skills.
The guides would encompass a “sociotechnical” model and look at hardware and software, clinical content, human-computer interface, people, workflow and communication, internal organizational features, external rules and regulations, and measurement and monitoring, according to the study protocol.
Procedures to develop the self-assessment guides include:
Step 1: Convening an expert panel and workgroup, inclusive of technical and experts, to provide guidance and advance the development of the guides
Step 2: An updated literature search to inform the guides’ development
Step 3: Stakeholder engagement for self-assessment guide’s development and distribution
Step 4: The development of self-assessment guides that focus on each of the nine individual high risk areas
Step 5: Solicitation of feedback about the questions and usefulness of the guides for the purpose of refinement
“The resulting products and lessons learned from the development of the assessment guides are expected to be helpful to organizations that are beginning the EHR selection and implementation process as well as those that have already implemented EHRs,” the authors wrote.
To view the study protocol, go here.