Informaticists offer EHR safety recommendations

As EHRs and other forms of health IT work their way into the nation’s healthcare system, an increasing number of stakeholders are offering their opinion concerning how the health IT transition should proceed.

The latest group is the American Medical Informatics Association (AMIA), which recently issued recommendations concerning the usability of electronic health record systems.

According to an article published in the association’s journal, "given the anticipated adoption of health IT, and the potential for increased health IT-related harm or potential error, the AMIA board of directors convened a task force of members drawn from academia, clinical practice and industry to produce a set of AMIA recommendations on enhancing patient safety and the quality of care with improved usability of EHR systems."

The task force met for over a year, and a range of subcommittees reviewed the literature on usability in health IT, current related activities underway at various U.S. federal agencies, and current federally funded research activities, among other things.

In particular, the task force considered the following issues related to health IT: (1) safe and effective use of EHR, (2) EHR usability, and (3) EHR usability-associated medical errors.

Among AMIA's recommendations:

  • Standardized use cases should be established and maintained for selected EHR functionalities…Standardizing and prioritizing a set of use cases for patient-safety sensitive EHR functions would provide the foundation for a process by which different EHR may be measured and certified.
  • Develop a core set of measures for adverse events related to health IT use:  Use cases will facilitate the development and validation of standardized performance measures for assessing the incidence of adverse events and medical errors. These measures should be developed with the participation of experts and representatives drawn from the measure development community, clinical informatics, end-users and the vendor community.
  • Develop and disseminate an educational campaign on the safe and effective use of EHR. The goal of the campaign would be to bring increased attention to issues of patient-safety sensitive functions of EHR or EHR modules, and to usability in general.


The study cited the airline industry as an example of an industry that has faced similar issues to health IT.

“The aircraft industry,” the article noted, “developed industry groups where topics are discussed and conventions sanctioned by a large number of airframe manufacturers and aviation software and hardware vendors. These cooperative efforts have occurred despite the intensely competitive nature of the aviation sector as competitors see value in working together in this arena.”

The full article and complete list of recommendations can be found here.