title: EHR safety: the way forward to safe and effective systems.
abstract: Diverse stakeholders--clinicians, researchers, business leaders, policy makers, and the public--have good reason to believe that the effective use of electronic health care records (EHRs) is essential to meaningful advances in health care quality and patient safety. However, several reports have documented the potential of EHRs to contribute to health care system flaws and patient harm. As organizations (including small hospitals and physician practices) with limited resources for care-process transformation, human-factors engineering, software safety, and project management begin to use EHRs, the chance of EHR-associated harm may increase. The authors propose a coordinated set of steps to advance the practice and theory of safe EHR design, implementation, and continuous improvement. These include setting EHR implementation in the context of health care process improvement, building safety into the specification and design of EHRs, safety testing and reporting, and rapid communication of EHR-related safety flaws and incidents.
authors.affiliation: Geisinger Health System, MC 30-06, 100 North Academy Avenue, Danville, PA 17822-3006, USA. jmwalker@geisinger.edu
authors.forename: James M
authors.initials: JM
authors.lastname: Walker
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
authors.forename: Nancy
authors.initials: N
authors.lastname: Leveson
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Paulus
authors.forename: John
authors.initials: J
authors.lastname: Tooker
authors.forename: Homer
authors.initials: H
authors.lastname: Chin
authors.forename: Albert
authors.initials: A
authors.lastname: Bothe
authors.forename: Walter F
authors.initials: WF
authors.lastname: Stewart
mesh_terms: D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D016347:Medical Records Systems, Computerized / Q000458:organization & administration / Q000592:standards*; D012449:Safety; D012984:Software / Q000592:standards