ONC Releases Safety Assurance Factors For “SAFER” Use Of EHR’s

Posted on by Frank J. Rosello

The Office of the National Coordinator for Health IT has released what it calls Safety Assurance Factors for EHR Resilience guides: nine toolkits to help providers make safer use of electronic health records and other technology.

The SAFER suite include checklists and recommended practices designed to help care providers and affiliated organizations optimize EHR safety. ONC officials say it’s an important component of the Health IT Patient Safety Action and Surveillance Plan issued by the Department of Health and Human Services this past July.

“A basic premise of the Health IT Safety Plan is that all stakeholders have a shared responsibility to make sure that health IT is safely implemented and that it is used to improve patient safety and care,” said Jacob Reider, MD, chief medical officer at ONC, in a press statement. “The SAFER Guides combine the latest applied knowledge of health IT safety with practical tools that will help providers – working closely with EHR developers, diagnostic service providers and others – effectively assess and optimize the safety and safe use of EHR technology within their organizations.”


Developed by health IT safety and informatics researchers – and based on the latest available evidence and field work – each SAFER Guide addresses a critical area associated with the safe use of EHRs through a series of self-assessment checklists, practice worksheets and recommended practices. The nine guides are:

  • High-priority practices
  • Organizational responsibilities
  • Patient identification
  • CPOE and decision support
  • Test results review and follow-up
  • Clinician communication
  • Contingency planning
  • System interfaces
  • System configuration

Writing on ONC’s Health IT Buzz blog, Reider makes the case that these guide come at a critical time.

“As a family physician who has worked for years on making sure that health information technology is leveraged to improve the safety and quality of health care, I’m thrilled to see the SAFER Guides fill a void: We’ve never before had a set of tools that care delivery organizations can use to perform self-assessments and developer customized improvement plans,” he wrote.

“There is good evidence that health information technology improves the safety of care, especially when implemented using best practices,” Reider added, pointing to a recent study from the Annals of Internal Medicine as evidence.

Nonetheless, “We’ve learned that there is a great deal of variability in how information technology is implemented and optimized in care delivery organizations, and this variability may account for some of the problems with the safety and reliability of health IT,” he wrote. “These guides help enhance the likelihood that health information technology is implemented in a manner that aligns with best practice.”



The SAFER Guides complement existing health IT safety tools developed by ONC and the Agency for Healthcare Research and Quality. AHRQ’s Patient Safety Organizations have explicitly identified health IT as a high priority, as EHRs critical mass and have a more significant impact on patient safety.

“With the release of these guides, stakeholders now have ready access to additional evidence-based knowledge and practical tools to optimize EHR safety,” said Jon White, MD, director of AHRQ’s Health IT portfolio, in a statement. “Consistent with the Health IT Safety Plan, health care providers and those who support them will use these guides to develop a culture of safety, shared responsibility, and continuous improvement around health IT.”

Each SAFER Guide has extensive references and is available as a downloadable PDF and as an interactive Web-based tool. Access them here.

Article written by Mike Miliard

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