Description
Background: Electronic health records (EHRs) are transforming the way healthcare is delivered. They are central to improving the quality of patient care and have been attributed to making healthcare more accessible, reliable and safe. However, in recent years, evidence suggests that specific features and functions of EHRs can introduce new, unanticipated patient safety concerns that can be mitigated by safe configuration practices. Objective: To develop a detailed and comprehensive evidence-based checklist of safe configuration practices for use by clinical informatics professionals when configuring hospital-based EHRs. Methods: A literature review was conducted to synthesize evidence on safe configuration practices; data were analyzed to elicit themes of common EHR system capabilities. Two rounds of testing were completed with end users to inform checklist design and usability. This was followed by a four-member expert panel review, where each item was rated for clarity (clear, not clear), and importance (high, medium, low). Results: An expert panel consisting of three clinical informatics professionals and one health information technology expert reviewed the checklist for clarity and importance. Medium and high importance ratings were considered affirmative responses. Of the 870 items contained in the original checklist, 535 (61.4%) received 100% affirmative agreement among all four panelists. Clinical panelists had a higher affirmative agreement rate of 75.5% (656 items). Upon detailed analysis items with 100% clinician agreement were retained in the checklist with the exception of 47 items and the addition of 33 items, resulting in a total of 642 items in the final checklist. Conclusions: Safe implementation of EHRs requires consideration of both technical and socio-technical factors through close collaboration of health IT and clinical informatics professionals. This presentation I will discuss life after development of the checklist and how we are implementing it at Alberta Health Services during the design and build phase of our new Provincial Electronic Health Record (Connect Care) - the largest implementation of its kind in Canada.
Describe the new knowledge and additional skills the participant will gain after attending your presentation.: By attending this session, participants will be able to:
- Define eSafety and provide examples of key initiatives across North America to improve the safety of EHRs
- Understand how the features, functions and configurations of EHRs can cause unanticipated harm
- Apply the eSafety checklist within their organization to audit, improve or implement an EHR
Authors:
Pritma Dhillon-Chattha (Presenter)
Alberta Health Services
Presentation Materials: