E-health records prompt safety focus

Texas researchers are calling for a national strategy to address patient safety in electronic health records (EHRs).

For example, hospitals need to prepare to provide timely care when the computer system running a hospital’s EHR system goes down, they say. That’s why the researchers would like to see contingency plans developed for such occasions, as well as a way to monitor new EHR-related patient safety issues that were not seen before.

Device failures and natural and man-made disasters are inevitable, says Dean Sittig, PhD, faculty member at the University of Texas Health Science Center at Houston, who specializes in clinical information systems and clinical decision support. Sittig was the lead author in the report.1 The potential consequences of an EHR failure become of increasing concern as large-scale EHR systems are deployed across multiple facilities within a healthcare system, often across a wide geographic area, he says.

“To create a coordinated, consistent, national, strategy that will address the safety issues posed by EHRs, we propose that a concerted effort be made to improve health care safety in the context of technology use,” Sittig and his colleagues say in the report. “This effort should address preventable risks that may hamper endeavors to create a safer EHR-enabled health care system.”

Further discussion and consensus is needed among national agencies such as the Office of the National Coordinator for Health Information Technology, the Agency for Healthcare Research and Quality, The Joint Commission, and the Centers for Medicare and Medicaid Services, the authors write. “However, this approach must be given immediate priority considering the rapid pace of EHR adoption and the resulting changes in our nation’s health care system,” the authors write in the report. “National EHR-related patient-safety goals are needed to address current problems with existing EHR implementations and failures to leverage current EHR capabilities.”

Goals must be technically feasible, financially prudent, and practically achievable within current constraints and be accompanied by specific guidance on achieving them, the authors say. Input on these goals must be sought not only from EHR developers and clinical end users, but also from cognitive scientists, human-factors engineers, graphic designers, and others with expertise in patient safety in complex healthcare environments.

“Creating unique EHR-related national patient-safety goals will provide new momentum for patient-safety initiatives in an EHR-enabled health system,” the authors write.


  1. Sittig DF, Singh H. Electronic health records and national patient-safety goals. NEJM 2012; 367:1,854-1,860.


  • Dean Sittig, PhD, School of Biomedical Informatics, The University of Texas Health Science Center at Houston. Telephone: (715) 500-7977. Email: dean.f.sittig@uth.tmc.edu.