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10-Point ONC Safety Plan Seeks to Improve EHR Use

Cheryl Clark, for HealthLeaders Media, July 9, 2013

New federal guidelines aim for electronic health record systems to be used in a way that improves care and patient safety, and to ensure that system designs don't make certain types of errors more likely to happen.

Providers will make fewer medical errors that can harm patients—at least in theory—after implementation of a federal health IT safety plan unveiled this month. The plan recommends prohibitions of so-called vendor contract gag clauses and says demonstration of electronic health record systems' safety features should be a prerequisite for certification.

The 10-point plan, issued by the Office of National Coordinator for Health IT, seeks to resolve problems highlighted in the Institute of Medicine's November, 2011 report, Health IT and Patient Safety: Building Safer Systems for Better Care, by allowing electronic health record system users to report on problems using the Common Formats protocol, under development by the Agency for Healthcare Research and Quality.

"Health information technology enables substantial improvements in health care quality and safety, compared to paper records," the ONC said in a fact sheet accompanying release of the plan. "Yet health IT can only fulfill its enormous potential if risks associated with its use are identified, if there is a coordinated effort to mitigate those risks, and if it is used to make care safer."

The 50-page report's two main purposes are to use electronic health records in a way that improves care and patient safety, and to make sure electronic health record and computerized physician order entry system designs don't make certain types of mistakes more likely to happen.

"Because health IT is so tightly integrated into care delivery today, the extent to which health IT may have caused or contributed to medical errors is often unclear," the report begins. "For example, determining whether an error was caused by or associated with health IT is problematic where:

 

  • "The harm to the patient could have been prevented by more sophisticated  or improved implementation of computerized physician order entry or CDs,; or
  • " The clinician did not use certain health IT functionality that could have prevented the error."
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