Dive Brief:

• The Pew Charitable Trusts, American Medical Association and MedStar Health's Center for Human Factors in Healthcare on Tuesday released a roadmap for EHR developers and providers to use in performing safety and usability assessments of EHR technologies.
• The 54-page report includes voluntary certification precepts and test cases for all stages of the EHR software lifecycle, from design and development through implementation and training. 
• The framework can also be used to identify potential harms associated with implementing and customizing EHRs.

Dive Insight:

The report comes as CMS Administrator Seema Verma is standing firm on requiring providers to use 2015 Edition certified EHRs  in 2019, because that version opens APIs, a crucial step in achieving full interoperability in healthcare.

To create the framework, the organizations reviewed the literature and gathered insight from doctors, nurses, pharmacists, patients, EHR vendors and health IT experts. This led to recommendations on ways to advance EHR safety and usability, as well as criteria for developing rigorous tests cases and sample test case scenarios.

To improve usability and safety, providers and vendors should view the product lifecycle as a series of six stages, each with specific needs:

• Promote a culture of safety that strives to optimize EHR systems to reduce hazards.
• Support the design and development of the EHR product to enhance qualities such as workflow and ease of use.
• During acquisition, match the appropriate product to the provider's specific needs.
• Customize the EHR's coding and configuration to support the needs of the healthcare organization.
• Implement and maintain a safe and usable EHR, including system upgrades when needed to address a safety issue.
• Train end users to use the EHR safely and effectively.

The framework is intended as a guide for developers and providers, rather than absolute rules, according to the organizations. "While the criteria provide a framework for factors that can be included in voluntary certification programs, each institution creating such a program would have to tailor it to its specific goals and mission," according to the report.

EHR errors resulting in patient harm are rare, but they do occur. According to a study last year by The Doctors Company, EHRs figured in 66 malpractice claims between July 2014 and December 2016, up from just two between 2007 and 2010. About a third of the allegations were related to diagnosis. 

The study also revealed problems with EHR systems, which factored in half of the claims. Issues included design, lack of integration of hospital EHRs and absence or failure of alerts and alarms.