It is important for all who work in informatics, especially those in academia, to acknowledge both the benefits as well as the harms of health information technology (HIT). As noted in a recent entry in this blog, an updated systematic review of HIT evaluation research shows there is clear value to the use of HIT in improve health and healthcare delivery outcomes.
But we also know that like any clinical intervention, HIT can have adverse effects. If not implemented safely, it can not only lead to harm, but also waste a great deal of money. We must therefore, just like with other interventions, implement HIT, especially the electronic health record (EHR), using best practices and keeping an eye for possible harms. The framework for HIT safety was laid out in a report from the Institute of Medicine in 2011. This report included a chapter on how to avoid "e-iatrogenesis". The lead author on the chapter was Oregon Health & Science University (OHSU) informatics faculty, Dr. Joan Ash, and I was one of her co-authors.
I are now pleased to report that Dr. Ash has co-led (along with Drs. Dean Sittig and Hardeep Singh of the University of Texas Health Science Center at Houston) important further contributions in HIT safety, which are the SAFER (Safety Assurance Factors for EHR Resilience) guides that were released by the Office of the National Coordinator for HIT (ONC) last week. These guides are based on the best known research evidence for optimizing implementation of the electronic health record (EHR) safety. Recent ONC Director Dr. Jacob Reider wrote in the ONC HIT Buzz Blog about the importance of the SAFER guides.
The SAFER guides, along with research about the value of HIT, also drive home the importance of informatics expertise in implementing HIT. Well-trained informaticians bring knowledge and experience to HIT implementation, including being aware of the existence of tools like the SAFER guides. These guides will allow informaticians and others to apply best practices to EHR implementation.