SBMI faculty co-author JAMA paper examining EHR safety assessment

UTHealth Houston School of Biomedical Informatics (SBMI) Professor Dean Sittig, PhD and Adjunct Professor Hardeep Singh, MD, MPH have a newly published paper in the Journal of the American Medical Association (JAMA). The paper explores systematic safety assessment of electronic health record (EHR) systems using the SAFER (Safety Assurance Factors for EHR Resilience) Guides Assessment. According to both researchers, “organizations that follow these guides should have a much safer and more efficient EHR.”

The SAFER Guides were developed by Drs. Sittig and Singh in 2014 and consist of nine guides that each fall within three different categories. In August of 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule mandating annual attestation of SAFER assessment completion for eligible hospitals. Having clinicians participate in the EHR safety evaluation process outlined within the SAFER assessment significantly aids organizations in enhancing both clinical and patient care.

Through comprehensive review and study, Drs. Sittig and Singh crafted concrete assessments that focus on reducing as many safety risks as feasible. “The guidelines for using the SAFER Guides presented in the JAMA article are the result of years of work by many people across multiple organizations,” noted Sittig.

Within the paper, the co-authors outline five important steps for completing the SAFER Guides Assessment. Those steps include building a SAFER team, determining what recommendations need EHR vendor support, bringing the team together to track progress, documenting and communicating about the status of implementation, and finally, prioritizing unmet recommendations to make needed changes.

Senior Associate Dean for Informatics at Vanderbilt University School of Nursing and co-author of the paper, Patricia Sengstack, DNP, has implemented the SAFER Guides in two health systems. She reports that “the recommendations contained within the guides provide the standards necessary for health care organizations to easily identify areas for safety improvement.”

Because the CMS rule impacts almost all hospitals, the researchers understand how impactful the assessment steps are in enhancing clinical safety practices.

“We think of the SAFER Guides Assessment as a major step in a hospital’s journey towards high reliability health care” said Singh, who also works at the Center for Innovations in Quality, Effectiveness and Safety and Michael E. DeBakey VA Medical Center. “Hospitals should also provide assessment results to their governing board and engage them in EHR safety improvement efforts.”

Visit JAMA’s website to read the full paper.