Source · HSSIB Patient Safety Investigation
Electronic patient record (EPR) systems – thematic review
HSSIB’s introductionWe have completed a thematic review of 50 HSSIB reports to identify specific patient safety issues and learning related to electronic patient record (EPR) systems. The report includes a safety observation and local-level learning prompts around safe selection and procurement, implementation and ongoing optimisation of EPR systems.
Published 27 November 2025
Published
NHS staff
Communication and decision making
Medical devices
Indexed content
1 observation
13 learning prompts
Safety Observations
National bodies responsible for providing digital advice and guidance to NHS organisations can improve patient safety by clarifying consistent definitions for design-related IT terms – such as usability and functionality – and sharing guidance on how to apply design principles to electronic patient record system configuration and optimisation.
Learning Prompts
How does your organisation identify requirements for an EPR system to account for organisational and user (patients and staff) needs?
How does your organisation identify whether an EPR system can perform the tasks needed to meet organisational requirements and meet expected national standards?
How does your organisation identify whether an EPR system meets relevant standards, such as those that support clinical risk management and interoperability?
How does your organisation ensure relevant information is requested from manufacturers and scrutinised during the selection and procurement of systems?
Does your organisation understand the expectations for clinical risk management of health IT systems in relation to deployment, ensuring these are met and regularly reviewed?
How does your organisation ensure representative user engagement and involvement in all aspects of the configuration, integration and ongoing optimisation of EPR systems?
Does your organisation have a process for carrying out effective equality impact assessments to consider the needs of specific patient and staff groups who may be users of the EPR system?
How does your organisation manage and oversee configuration changes to EPR systems to ensure they are appropriate, safe and successful?
How does your organisation evaluate whether all necessary elements are in place before an EPR system is implemented or changed, for example through assessment of IT infrastructure and training?
How does your organisation proactively identify new and emerging risks associated with an EPR system, and ensure these are reviewed and mitigated as far as is practicable?
Does your organisation have routes for staff to raise concerns about the EPR system they use, with feedback to inform staff of actions taken in response?
Does your organisation have contingency plans and processes to maintain patient safety when there are EPR system problems, and are they shared with staff?
How does your organisation share learning from the implementation and ongoing optimisation of EPR systems to support other organisations?