25% of organizations fully adhere to ONC's SAFER guidelines for EHRs

Healthcare organizations’ adherence to the Office for the National Coordinator for Health Information Technology (ONC) Safety Assurance Factors for EHR Resilience (SAFER) guidelines is low, according to a study published April 26 in the Journal of Information in Health and Biomedicine.


In 2014, ONC released the SAFER guidelines for healthcare systems to conduct risk assessments of their electronic health records (EHRs) to identify the level of safety on patient data. These guidelines included recommendations for safety related policies, processes, procedures and configurations. In this study, researchers evaluated eight healthcare systems in their adherence to the 140 SAFER recommendations.

Researchers evaluated eight healthcare organization of different sizes, complexity and EHR adoption maturity. The organizations provided a self-assessment of adherence to all 140 of the SAFER recommendations in nine guidelines. Each guideline was organized into either “safe health IT” (45 recommendations), “using health IT safely” (80 recommendations) and “monitoring health IT” (15 recommendations).

Results showed the eight organizations had only fully implemented 25 out of the 140 (18 percent) SAFER recommendations. System Interfaces, which included 18 recommendations, was the most implemented guideline with 94 percent of organizations reporting it to be fully implemented, followed by clinical communication at 63 percent with 12 recommendations.

“Despite availability of recommendations on how to improve use of EHRs, most recommendations were not fully implemented,” concluded first author Dean Sittig, and colleagues. “New national policy initiatives are needed to stimulate implementation of these best practices.”