Electronic health records and national patient-safety goals

This is a review of Sittig and Singh's 2012 NEJM article "Electronic Health Records and National Patient-Safety Goals."

Introduction

EHRs have been widely implemented since the US government incentivized their use in 2009, but this widespread and rapid implementation has been extremely heterogeneous across health care organizations, meaning that many organizations are in various stages of implementing and using EHRs. This heterogeneity of EHR use has variable implications for patient safety, and Sittig and Singh proposed a 3-phase framework for addressing EHR-related patient safety across organizations with all levels of EHR implementation and use.

Goals

Phase 1: Address Safety Concerns Unique to EHR Technology

It is first important to make sure that EHR technology is safe (from things like device failures due to man-made or natural disasters and from miscommunications/erroneous transfers of information that could occur between system components). Potential electronic or "e" patient safety goals (PSGs) would be to "reduce the effect of EHR downtime on clinical operations and patient safety" and to reduce "the miscommunication of data transmitted between different safety-critical components of the EHR."