Assessing the Adherence to Recommended Health Information Technology Safety Practices: A Case Study of a Nuclear Medicine and Molecular Imaging Center

Abstract

3025 Introduction: The rapid advances in health information technology (IT) and their increasing adoption rates paved the way for unintended consequences; some can cause harm to patients.1 Today, Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) are mission-critical components of any modern healthcare, but can also cause harm to patients if not designed, adopted, and used appropriately.2 The goal of this work is to conduct a proactive risk assessment of safety-related policies, processes, procedures, and configurations of the health IT environment at a nuclear medicine and medical imaging center. Methods: We conducted a risk assessment of a specialized nuclear medicine and molecular public imaging center in the State of Kuwait. The risk assessment targeted the current implementation of the RIS and PACS at the center. The Safety Assurance Factors for EHR Resilience (SAFER) guides3 were used for the evaluation. The self-assessment examined the adherence to 140 unique SAFER recommendations contained within 9 guides spanning across 3 broad groups: “safe health IT”; “using health IT safely”; and “monitoring health IT”. Technical staff and clinicians filled out the assessments using the SAFER guides and have interviewed the relevant stakeholders in the center including IT, admin, and nuclear medicine physician. Results: The center fully implemented 112 of 140 (80%) of the SAFER recommendations. The lowest adherence to the recommendations was attributed to Clinician Communications while the highest was attributed to Contingency Planning and System Interfaces. Table 1 overviews the adherence scores across the 9 guide areas. Conclusions: While the SAFER guides mainly apply to electronic health records, it was useful to use them to evaluate the safety of the current RIS and PACS implementation. Completing the self-assessment was helpful to expose weaknesses and involving various stakeholders to own health IT-related patient safety. Commitment to health IT safety and the full implementation of the SAFER recommendations necessitates top leadership support, organizational prioritization, policy and workflow modifications, as well as vendor/supplier participation.4Acknowledgments: We would like to thank Eng. Ravi Charles for his contribution in this study. References: 1. Sittig DF, Wright A, Ash J, Singh H. New Unintended Adverse Consequences of Electronic Health Records. Yearb Med Inform. 2016 Nov 10;(1):7–12. 2. Savoie B, Nagy P. PACS and the potential for medical errors. J Am Coll Radiol JACR. 2012 Oct;9(10):756–8. 3. Sittig DF, Ash JS, Singh H. The SAFER guides: empowering organizations to improve the safety and effectiveness of electronic health records. Am J Manag Care. 2014 May;20(5):418–23. 4. Sittig DF, Salimi M, Aiyagari R, Banas C, Clay B, Gibson KA, et al. Adherence to recommended electronic health record safety practices across eight health care organizations. J Am Med Inform Assoc JAMIA. 2018 01;25(7):913–8. Supporting Data: Table 1: Adherence scores to SAFER guide recommended practices.

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