SAFER Guides
The 2025 SAFER guides have been updated and streamlined to focus on the highest risk, most commonly occurring issues that can be addressed through technology or practice changes to build system resilience.
The 2025 SAFER Guides consist of eight guides organized into three broad groups. These guides enable healthcare organizations to address EHR safety in a variety of areas. Most organizations will want to start with the Foundational Guides and proceed from there to address their areas of greatest interest or concern. The guides identify recommended practices to optimize the safety and safe use of EHRs. The content of the guides can be explored here, at the links below, or interactive PDF versions of the guides can be downloaded and completed locally for self-assessment of an organization’s degree of conformance to the Recommended Practices.
2025 SAFER Guides
Foundational Guides
The High Priority Practices SAFER Guide includes 16 recommendations selected from the other seven guides because of their relevance and importance for practicing clinicians to understand and support.
High Priority Practices [PDF – 1.9 MB]
The Organizational Responsibilities SAFER Guide identifies individual and organizational responsibilities (activities, processes, and tasks) intended to optimize the safety and safe use of EHRs. A key addition to this revised guide relates to the use of Artificial Intelligence (AI)*- enabled systems, or EHRs with enhanced AI features or functions for the administration, diagnosis, treatment, and management of patient care.
Organizational Responsibilities [PDF – 1.9 MB]
Infrastructure Guides
The Contingency Planning SAFER Guide identifies recommended safety practices associated with planned or unplanned EHR unavailability — instances in which clinicians or other end users cannot access all or part of the EHR.
Contingency Planning [PDF – 1.8 MB]
The System Management Guide identifies recommended safety practices associated with the configuration, validation, and maintenance of electronic health record (EHR) hardware, software, and system-to-system application programming interfaces (APIs). This includes the physical environment in which the EHR will operate and the implementation and testing of technically complex components of the clinical information system.
System Management PDF – 1.7 MB]
Clinical Process Guides
The Patient Identification SAFER Guide identifies recommended safety practices associated with the reliable identification of patients in the EHR. Accurate patient identification ensures that the information displayed and entered into the EHR is associated with the correct person. Processes related to patient identification are complex and require careful planning and attention to avoid errors.
Patient Identification [PDF – 1.8 MB]
The Computerized Provider Order Entry with Decision Support SAFER Guide identifies recommended safety practices associated with the design, implementation, use, and monitoring of orders and clinical decision support (CDS). This includes order structure, mapping, libraries, alerts, and warnings that users rely on during patient care.
Computerized Provider Order Entry with Decision Support [PDF – 1.4 MB]
The Test Results Reporting and Follow-Up SAFER Guide identifies recommended safety practices intended to optimize the safety and safe use of processes and EHR technology for the electronic communication and management of test results.
Test Results Reporting and Follow-Up [PDF – 1.8 MB]
The Clinician Communication SAFER Guide identifies recommended safety practices for communication among clinicians, care teams, and patients. This guide focuses on ensuring reliable electronic communication using EHR-related messaging systems (e.g., SMS text messages, secure text messages, and EHR-based clinician-to-clinician messages) to facilitate care transitions such as discharges and referrals, and patient portal-related communication.
Clinician Communication [PDF – 1.6 MB]
SAFER Guide Measures
The previous versions of the SAFER Guides, published in 2016, continue to be applicable for the SAFER Guides measures included in the Medicare Promoting Interoperability Program for eligible hospitals and CAHs and the Promoting Interoperability performance category of the Merit Based Incentive Payment System (MIPS). You can learn more about the SAFER Guides measures in these programs and relevant requirements from the CMS SAFER Guides Infographic [PDF – 301 KB]