Adoption of ONC’s SAFER EHR Safety Guidelines is Low, Study Finds

Despite the release four years ago of broadly available electronic health record (EHR) safety guidelines and recommendations, provider adherence to the guidelines is low, a new study finds.

The Office of the National Coordinator for Health IT (ONC) released the Safety Assurance Factors for EHR Resilience (SAFER) guides in 2014 and updated in 2017 to help health systems conduct proactive risk assessment of EHR safety-related policies, processes, procedures, and configurations. The extent to which organizations adopted and implemented these guidelines is unknown, so the guideline authors conducted a survey to determine just that.

To do this, according to the survey results, which were published in the Journal of Informatics in Health and Biomedicine, investigators conducted risk assessments of eight organizations of varying size, complexity, and EHR adoption maturity. Then, those organizations self-assessed adherence to all 140 unique SAFER recommendations outlined in the guides in three domains: safe health IT, using health IT safely, and monitoring health IT, according to the study abstract.

According to an EHRIntelligence.com article analyzing of the results, adoption of the guidelines is less than stellar. Only 25 of the 140 recommendations were fully implemented.

Twenty-five of 140 SAFER recommendations were fully implemented at the eight organizations, “while the mean percentage of ‘fully implemented’ SAFER recommendations ranged from 94 percent for the System Interfaces guide down to 63 percent for the Clinician communication guide,” according to the article. Additionally, of the 11 recommendations most likely to be “not implemented,” most were from three guides: Test Results Reporting, Communication, and CPOE/CDS. Four of these recommendations were from the CPOE/CDS guide.

“Uptake of the remaining SAFER recommendations will likely increase as organizations become more confident in their abilities to develop new policies, procedures, clinical workflows, and configure and maintain their EHR implementations,” the researchers wrote, according to article. “Finally, full implementation of the SAFER recommendations will require organizational prioritization, resource allocation, policy changes, and vendor participation.”

Mary Butler is the associate editor at Journal of AHIMA.

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