National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018

Key Points Question How did safety performance of electronic health record systems (EHRs) change in the US from 2009 to 2018? Findings In this case series using 8657 hospital-year observations from adult hospitals nationwide that used the National Quality Forum Health IT Safety Measure, a computerized physician order entry and EHR safety test, from 2009 to 2018, mean scores on the overall test increased from 53.9% in 2009 to 65.6% in 2018. There was considerable variation in test performance by hospital and EHR vendor. Meaning These findings suggest that, despite broad adoption and optimization of EHR systems in hospitals, wide variation in the safety performance of operational EHR systems remains across a large sample of hospitals and EHR vendors, and serious safety vulnerabilities persist in these operational EHRs.