Making electronic health records both SAFER and SMARTER.

Kevin B Johnson; William W Stead

Commentary

Making electronic health records both SAFER and SMARTER.

July 27, 2022

Johnson KB, Stead WW. JAMA. 2022;328(6):523-524.

View more articles from the same authors.

Electronic health record (EHR) system implementation should optimize interoperability and support clinician decision making. This commentary discusses a strategy to aid in the sociotechnical design of interfaces and involvement of the myriad of individuals that use EHRs, including patients.

PubMed citation

Free full text

Related Resources From the Same Author(s)

Policies to promote shared responsibility for safer electronic health records.

September 29, 2021

Hospital-acquired SARS-CoV-2 infection: lessons for public health.

December 9, 2020

Guidelines for US hospitals and clinicians on assessment of electronic health record safety using SAFER Guides.

February 16, 2022

Electronic health record interoperability-why electronically discontinued medications are still dispensed.

September 22, 2021

Association of state-level opioid-reduction policies with pediatric opioid poisoning.

August 5, 2020

Another medical malpractice crisis?: Try something different.

October 14, 2020

A learning health system agenda for organizational approaches to enhancing occupational well-being among clinicians.

May 25, 2022

Diagnostic excellence through the lens of patient-centeredness.

December 8, 2021

To err is human, to apologize is hard.

August 4, 2021

Association of hospital public quality reporting with electronic health record medication safety performance.

October 6, 2021

Electronic health record legal settlements in the US since the 2009 Health Information Technology for Economic and Clinical Health Act.

December 21, 2022

Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.

September 2, 2020

Cognitive bias and public health policy during the COVID-19 pandemic.

July 22, 2020

An evolving hospital quality star rating system from CMS: aligning the stars.

May 26, 2021

Rapid response teams as a patient safety practice for failure to rescue.

July 7, 2021

Trends in adverse event rates in hospitalized patients, 2010-2019.

July 27, 2022

Association of electronic health record use above meaningful use thresholds with hospital quality and safety outcomes.

October 21, 2020

Cognitive testing of older clinicians prior to recredentialing.

February 5, 2020

Association of display of patient photographs in the electronic health record with wrong-patient order entry errors.

December 2, 2020

Association of anesthesiologist staffing ratio with surgical patient morbidity and mortality.

August 3, 2022

Professional behavior and value erosion: a qualitative study of physicians and the electronic health record.

November 9, 2022

Association between hospital acquired harm outcomes and membership in a national patient safety collaborative.

August 10, 2022

Impact of smart pump-electronic health record interoperability on patient safety and finances at a community hospital

August 25, 2021

Experiences and perspectives of transgender youths in accessing health care: a systematic review.

August 4, 2021

Notes on healing after a missed diagnosis.

October 19, 2022

Journal Article

Study

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

November 16, 2022

Prevalence and sources of duplicate information in the electronic medical record.

October 12, 2022

Fatal Solutions: How a Healthcare System Used Tragedy to Transform Itself and Redefine Just Culture.

October 5, 2022

Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids.

August 25, 2021

A national mixed-methods evaluation of preparedness for general surgery residency and the association with resident burnout.

September 2, 2020

US emergency department visits attributed to medication harms, 2017-2019.

October 20, 2021

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis.

July 8, 2020

Misdiagnosis in the emergency department: time for a system solution.

February 8, 2023

Association of patient and family reports of hospital safety climate with language proficiency in the US.

June 29, 2022

Nonopioid directives: unintended consequences in the operating room.

June 29, 2022

Diagnostic stewardship to prevent diagnostic error.

March 15, 2023

Surgical site infection prevention: a review.

February 1, 2023

Association between surgeon technical skills and patient outcomes.

September 9, 2020

Physician use of stigmatizing language in patient medical records.

July 28, 2021

Communication through the electronic health record: frequency and implications of free text orders.

July 29, 2020

Effect of different interventions to help primary care clinicians avoid unsafe opioid prescribing in opioid-naive patients with acute noncancer pain: a cluster randomized clinical trial.

September 7, 2022

The MedSafer study-electronic decision support for deprescribing in hospitalized older adults: a cluster randomized clinical trial.

February 2, 2022

Workarounds in electronic health record systems and the revised Sociotechnical Electronic Health Record Workaround Analysis Framework: scoping review.

April 13, 2022

A sociotechnical framework for safety-related electronic health record research reporting: the SAFER reporting framework.

June 24, 2020

Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.

April 3, 2005

Remote patient monitoring during COVID-19: an unexpected patient safety benefit.

March 23, 2022

Restructuring of a general surgery residency program in an epicenter of the coronavirus disease 2019 pandemic: lessons from New York City.

July 29, 2020

Assessment of perioperative outcomes among surgeons who operated the night before.

June 8, 2022

Toward constructive change after making a medical error: recovery from situations of error theory as a psychosocial model for clinician recovery.

August 10, 2022

Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices.

June 30, 2021

Improving clinician well-being and patient safety through human-centered design.

March 8, 2023

Reporting of death in US Food and Drug Administration medical device adverse event reports in categories other than death.

August 11, 2021

Prevalence of undiagnosed diabetes identified by a novel electronic medical record diabetes screening program in an urban emergency department in the US.

February 22, 2023

Adherence to national guidelines for timeliness of test results communication to patients in the Veterans Affairs health care system.

May 4, 2022

Long-term risk of overdose or mental health crisis after opioid dose tapering.

July 13, 2022

Association between parent comfort with English and adverse events among hospitalized children.

November 11, 2020

A standardized formulary to reduce pediatric medication dosing errors: a mixed methods study.

October 6, 2021

Multilevel factors associated with time to biopsy after abnormal screening mammography results by race and ethnicity.

July 6, 2022

Guidance for health care leaders during the recovery stage of the COVID-19 pandemic: a consensus statement.

July 28, 2021

Quality measures for patients at risk of adverse outcomes in the Veterans Health Administration: expert panel recommendations.

August 17, 2022

Association of inappropriate outpatient pediatric antibiotic prescriptions with adverse drug events and health care expenditures.

June 8, 2022

Safety gaps in medical team communication: closing the loop on quality improvement efforts in the cardiac catheterization lab.

June 8, 2022

Racial disparities in child abuse medicine.

November 3, 2021

Patient and hospital characteristics associated with delayed diagnosis of appendicitis.

February 1, 2023

Wrong-site surgery.

December 13, 2017

Association of past and future paid medical malpractice claims.

March 1, 2023

Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19.

June 22, 2022

Race as a social construct in psychiatry research and practice.

December 22, 2021

Emotional exhaustion among US health care workers before and during the COVID-19 pandemic, 2019-2021.

October 5, 2022

Safer prescribing for hospitalized older adults with an electronic health records‐based prescribing context.

October 28, 2020

Personal formularies of primary care physicians across 4 health care systems.

August 4, 2021

Association of diagnostic stewardship for blood cultures in critically ill children with culture rates, antibiotic use, and patient outcomes: results of the Bright STAR Collaborative.

May 18, 2022

Impact of an electronic health record alert on inappropriate prescribing of high-risk medications to patients with concurrent "do not give" orders.

August 3, 2022

Health care-associated infections among critically ill children in the US, 2013-2018.

October 28, 2020

Concordance of hospital ranks and category ratings using the current technical specification of US Hospital Star Ratings and reasonable alternative specifications.

August 31, 2022

Effectiveness and efficiency of root cause analysis in medicine.

February 27, 2008

Complexity and challenges of the clinical diagnosis and management of Long COVID.

November 30, 2022

Physicians' experiences with mistreatment and discrimination by patients, families, and visitors and association with burnout.

June 1, 2022

Evaluation of policies limiting opioid exposure on opioid prescribing and patient pain in opioid-naive patients undergoing elective surgery in a large American health system.

March 8, 2023

Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error methodology in an integrated health system.

May 12, 2021

The path to diagnostic excellence includes feedback to calibrate how clinicians think.

February 20, 2019

Experiences of transgender people reviewing their electronic health records, a qualitative study.

June 29, 2022

Association of surgeon-patient sex concordance with postoperative outcomes,

December 22, 2021

Safety culture as a patient safety practice for alarm fatigue.

October 13, 2021

Use of recalled devices in new device authorizations under the US Food and Drug Administration's 510(k) pathway and risk of subsequent recalls.

January 25, 2023

Nurse well-being: a concept analysis.

August 17, 2022

The emotional fallout from the culture of blame and shame.

October 18, 2017

Inaccurate penicillin allergy labeling, the electronic health record, and adverse outcomes of care.

August 24, 2022

Poetry and Medicine. Mistakes.

September 25, 2019

Employee silence in health care: charting new avenues for leadership and management.

August 3, 2022

Association between operative autonomy of surgical residents and patient outcomes.

March 23, 2022

A qualitative analysis of the impact of electronic health records (EHR) on healthcare quality and safety: clinicians' lived experiences.

March 30, 2022

Accuracy of practitioner estimates of probability of diagnosis before and after testing.

May 5, 2021

Making polypharmacy safer for children with medical complexity.

April 5, 2023

Clinical and financial implications of second-opinion surgical pathology review.

April 7, 2021

Analysis of variation between diagnosis at admission vs discharge and clinical outcomes among adults with possible bacteremia.

July 13, 2022

Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States.

June 22, 2022

A multisite study of interprofessional teamwork and collaboration on general medical services.

November 25, 2020

Automated dispensing cabinet overrides-an evaluation of necessity in a pediatric emergency department.

May 25, 2022

Deferral of care for serious non-COVID-19 conditions: a hidden harm of COVID-19.

November 18, 2020

Related Resources

Patient safety of perioperative medication through the lens of digital health and artificial intelligence.

June 28, 2023

Patient Safety Innovations

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

May 31, 2023

Racism and electronic health records (EHRs): perspectives for research and practice.

April 12, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

Quality and safety: learning from the past and (re)imagining the future.

March 29, 2023

Improving diagnostic decision support through deliberate reflection: a proposal.

November 9, 2022

Professional behavior and value erosion: a qualitative study of physicians and the electronic health record.

November 9, 2022

Emergency preparedness: be ready for unanticipated electronic health record (EHR) downtime.

September 7, 2022

Inaccurate penicillin allergy labeling, the electronic health record, and adverse outcomes of care.

August 24, 2022

An evolution of reporting: identifying the missing link.

August 10, 2022

Experiences of transgender people reviewing their electronic health records, a qualitative study.

June 29, 2022

Applying requisite imagination to safeguard electronic health record transitions.

May 18, 2022

How health systems decide to use artificial intelligence for clinical decision support.

April 6, 2022

Is electronic health record safety a paradox?

February 23, 2022

Enabling a learning healthcare system with automated computer protocols that produce replicable and personalized clinician actions.

August 4, 2021

Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.

June 30, 2021

Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems.

January 13, 2021

Hospitals Can Take Key Steps to Improve Safe Use of Digital Systems.

August 12, 2020

Patient safety and quality improvement: ethical principles for a regulatory approach to bias in healthcare machine learning.

July 22, 2020

WebM&M Cases

Direct Oral Anticoagulants are High-Risk Medications with Potentially Complex Dosing

June 24, 2020

How common mental shortcuts can cause major physician errors.

March 4, 2020

To catch a killer: electronic sepsis alert tools reaching a fever pitch?

August 28, 2019

Hidden health IT hazards: a qualitative analysis of clinically meaningful documentation discrepancies at transfer out of the pediatric intensive care unit.

August 28, 2019

Safe Practices for Drug Allergies—Using CDS and Health IT.

August 7, 2019

Perspective

Emerging Safety Issues in Artificial Intelligence

July 1, 2019

Interview

In Conversation With… Suchi Saria, PhD

July 1, 2019

Using near-miss events to improve MRI safety in a large academic centre.

May 15, 2019

What's in a name? Provider perception of injured John Doe patients.

April 3, 2019

Death by 1,000 clicks: where electronic health records went wrong.

March 27, 2019

Artificial intelligence systems for complex decision-making in acute care medicine: a review.

March 13, 2019

See More About The Topic

Hospitals

Health Care Executives and Administrators

Information Professionals

Latent Errors

Computerized Decision Support

Making electronic health records both SAFER and SMARTER.

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Making electronic health records both SAFER and SMARTER.

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site