Benchmarking Pie Visualization
White paper

Aligning EHRs with Quality and Safety:
A Framework and Benchmarking

Key insights:
  • The 4E’s Framework can be used by health systems to evaluate how well an EHR implementation supports quality and safety
  • Organizational strategy and capabilities contextualize EHR deficiencies and outline appropriate dimensions to benchmark
  • Measures of EHR Efficiency are often the most accurate to benchmark and are most likely to provide “low hanging fruit”
  • Interruptive alerts with high override rates provide an opportunity to leverage end-user feedback to iteratively improve care processes
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The Report

This white paper summarizes a methodology for evaluating how one’s Electronic Health Record (EHR) supports quality improvement and patient safety. It includes a framework (The 4E’s of EHR Evaluation) to assess the relative strengths and weaknesses of an EHR as well as data and insights from cross-institution benchmarking to provide real-world evidence and examples.


The Phrase Health team canvassed the literature to determine applicable frameworks to assess performance of the EHR as it relates to quality and patient safety. Key studies (e.g. Crossing the Quality Chasm from the Institute of Medicine) informed the model as the team iterated and tested it with quality, safety, and informatics leaders. The group then developed and aligned EHR-tool related metrics to the framework in order to compare participating health systems’ performances along these dimensions.


Phrase Health gives you access to rich data to improve the performance of your EHR