VA electronic health records research shaped new Medicare policy

Guides developed by VA researchers to promote safe use of electronic health records are part of a new federal policy on Medicare reimbursement to hospitals, which will take effect in January 2022.

The policy calls for hospitals to take advantage of extensive guides and checklists developed based on years of research by Dr. Hardeep Singh and his team at the Michael E. DeBakey VA Medical Center in Houston. His main collaborator and co-developer has been Dr. Dean Sittig, a professor at UTHealth School of Biomedical Informatics.

Through a series of studies, the researchers developed a comprehensive compendium of safety checklists known as the SAFER Guides.

“SAFER” stands for “Safety Assurance Factors for EHR Resilience.” “EHR” is shorthand for electronic health records. The guides are sponsored by the Office of the National Coordinator for Health Information Technology in the Department of Health and Human Services.

Singh is a professor at Baylor College of Medicine and an investigator at the Center for Innovations in Quality, Effectiveness and Safety (IQuESt), a VA-funded research center at the DeBakey VA Medical Center.

With the new Medicare payment rules, all U.S. hospitals eligible for reimbursement will have to attest annually that they have assessed their electronic health record use based on the SAFER Guides.

The guides cover areas such as communication among clinicians, test results reporting and follow-up, and contingency planning. They walk hospital personnel through detailed steps to ensure they are using electronic health records as safely as possible. Use of the SAFER Guides is one of several requirements and measures in the new Medicare rules.

“This new measure will stimulate hospitals to self-assess various aspects of their EHR-related patient safety proactively, without posing much additional measurement or reporting burden,” notes Singh. “We see this as a landmark development in EHR safety policy that impacts all U.S. hospitals.”

Singh’s research in general has focused on understanding and reducing diagnostic errors; using health information technology to improve health care; and improving the safety of electronic health records. In 2016, he and his team received the Health System Impact Award from VA Health Services Research & Development.

Singh and Sittig have authored or coauthored many influential journal articles reporting findings on patient safety and health information technology, and offering recommendations on how VA and other health care systems could improve in this area.

Singh says it’s gratifying to see how “the products and innovations we create as researchers can impact policy and practice at the national level.”