Childhood Obesity Preventer

With nearly 100% of community health centers utilizing electronic health records (EHR) to care for patients, focus has pivoted from implementation and new workflow development to enhancement in order to drive value and reflect patient needs and population trends. EHR technology presents potential opportunities and significant constraints. Providers frequently document and share potentially sensitive information in the EHR, such as risk for intimate partner violence (IPV), consistent offers of pre-exposure prophylaxis (PrEP), or patient sexual orientation and gender identity (SOGI). Capturing such information can be immensely helpful in providing care tailored to individuals’ needs, but additionally challenges teams to develop workflows that keep the data private rather than risk harm to patients through improper or unintended disclosure.

The High Priority Practices SAFER Guide identifies “high risk” and “high priority” recommended safety practices intended to optimize the safety and safe use of EHRs. It broadly addresses the EHR safety concerns discussed in greater detail in the other eight SAFER Guides.

The Organizational Responsibilities SAFER Guide identifies individual and organizational responsibilities (activities, processes, and tasks) intended to optimize the safety and safe use of EHRs. A safe EHR implementation is critically dependent on the people involved.

The Contingency Planning SAFER Guide identifies recommended safety practices associated with planned or unplanned EHR unavailability—instances in which clinicians or other end users cannot access all or part of the EHR. Occasional temporary unavailability of EHRs is inevitable, due to failures of software and hardware infrastructure, as well as power outages and natural and man-made disasters. Such unavailability can introduce substantial safety risks to organizations that have not adequately prepared.

The System Configuration SAFER Guide identifies recommended safety practices associated with the way EHR hardware and software are set up (“configured”). EHR configuration includes the creation and maintenance of the physical environment in which the system will operate, as well as the implementation of the required hardware and software infrastructure.

The System Interfaces SAFER Guide identifies recommended safety practices intended to optimize the safety and safe use of system-to-system interfaces between EHR-related software applications. Many healthcare organizations are involved in planning, implementing, or maintaining enterprise- or community-wide clinical information systems that require integration.

The Patient Identification SAFER Guide identifies recommended safety practices associated with the reliable identification of patients in the EHR. Accurate patient identification ensures that the information presented by and entered into the EHR is associated with the correct person. Processes related to patient identification are complex and require careful planning and attention to avoid errors.

The Computerized Provider Order Entry with Decision Support SAFER Guide identifies recommended safety practices associated with Computerized Provider Order Entry (CPOE) and Clinical Decision Support (CDS). Completing this self-assessment in collaboration with a multi-disciplinary team will help an organization optimize the safety and safe use of CPOE with CDS in the EHR.

The Test Results Reporting and Follow-Up SAFER Guide identifies recommended safety practices intended to optimize the safety and safe use of processes and EHR technology for the electronic communication and management of diagnostic test results. Processes relating to test results are fragile, requiring careful planning, implementation, and maintenance to deliver correct information promptly to the intended recipients.

The Clinician Communication SAFER Guide identifies recommended safety practices associated with communication between clinicians and is intended to optimize the safety and safe use of EHRs. Processes relating to clinician communication are complex and vulnerable to breakdown.