RxInformatics.com

Recent passage of the American Reinvestment and Recovery Act (ARRA) increases pressure on health care practitioners and organizations to implement currently available electronic health records (EHRs). Research and experience gained to date show that such implementation efforts are difficult, costly, time-consuming, and fraught with many unintended consequences.¹ Evaluation of these systems after implementation suggests that they do not routinely meet safety standards of other safety-critical industries.² The aggressive timeline proposed in the ARRA bill means that a large number of practitioners and health care organizations will soon be attempting a monumental feat without the time or ability to customize these systems to their local workflows.³

This proposed framework has 5 essential components: (1) ability for practitioners and organizations to report patient safety events or potential hazards related to EHR use^5-6; (2) enhanced EHR certification that includes specific assurances that good software development procedures⁷ have been followed along with evidence that previously reported adverse events and hazards have been addressed; (3) self-assessment, attestation, testing, and reporting by both clinicians and health care organizations that all 8 dimensions of safe EHR use have been addressed; (4) local, state, and national oversight in the form of an onsite, in-person accreditation of EHRs as implemented and used by clinicians in the health care setting; and (5) a national EHR-related adverse event investigation board that reviews incident reports and has the authority to investigate.

Thoughtful editorial regarding the impact of ARRA on the development, implementation and use of EHRs.