Policy ArticleCreating an Oversight Infrastructure for Electronic Health Record–Related Patient Safety HazardsSingh, Hardeep MD, MPH*; Classen, David C. MD, MS†; Sittig, Dean F. PhD‡Author Information From the *Houston VA Health Services Research and Development Center of Excellence and The Houston VA Patient Safety Center of Inquiry, Michael E. DeBakey Veterans Affairs Medical Center and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas; †University of Utah and CSC, Salt Lake City, Utah; and ‡University of Texas – Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Sciences Center, Houston, Texas. Correspondence: Dean F. Sittig, PhD, UT - Memorial Hermann Center for Healthcare Quality & Safety, University of Texas School of Health Information Sciences at Houston, 6410 Fannin St. UTPB 1100.13, Houston, TX 77030 (email: [email protected]). Conflicts of Interest and Source of Funding: Dr Singh is supported by a National Institutes of Health K23 career development award (K23CA125585), the VA National Center of Patient Safety, Agency for Health Care Research and Quality, a SHARP contract from the Office of the National Coordinator for Health Information Technology (ONC no. 10510592), and in part by the Houston VA Health Services Research and Development Service Center of Excellence (HFP90-020). Dr Sittig is supported in part by a grant from the National Library of Medicine R01-LM006942 and by a SHARP contract from the Office of the National Coordinator for Health Information Technology (ONC no. 10510592). Dr Classen is an employee of CSC, a technology services company. These sources had no role in the preparation, review, or approval of the article. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or any of the other funding agencies. Journal of Patient Safety: December 2011 - Volume 7 - Issue 4 - p 169-174 doi: 10.1097/PTS.0b013e31823d8df0 Buy Metrics Abstract Electronic health records (EHRs) have potential quality and safety benefits. However, reports of EHR-related safety hazards are now emerging. The Office of the National Coordinator for Health Information Technology recently sponsored an Institute of Medicine committee to evaluate how health information technology use affects patient safety. In this article, we propose the creation of a national EHR oversight program to provide dedicated surveillance of EHR-related safety hazards and to promote learning from identified errors, close calls, and adverse events. The program calls for data gathering, investigation/analysis, and regulatory components. The first 2 functions will depend on institution-level EHR safety committees that will investigate all known EHR-related adverse events and near-misses and report them nationally using standardized methods. These committees should also perform routine safety self-assessments to proactively identify new risks. Nationally, we propose the long-term creation of a centralized, nonpartisan board with an appropriate legal and regulatory infrastructure to ensure the safety of EHRs. We discuss the rationale of the proposed oversight program and its potential organizational components and functions. These include mechanisms for robust data collection and analyses of all safety concerns using multiple methods that extend beyond reporting, multidisciplinary investigation of selected high-risk safety events, and enhanced coordination with other national agencies to facilitate broad dissemination of hazards information. Implementation of this proposed infrastructure can facilitate identification of EHR-related adverse events and errors and potentially create a safer and more effective EHR-based health care delivery system. © 2011 Lippincott Williams & Wilkins, Inc.