scholarly journals Digital Waste? Unintended Consequences of Health Information Technology

2019 ◽  
Author(s):  
Petri Bockerman ◽  
Mika Kortelainen ◽  
Liisa Laine ◽  
Mikko Nurminen ◽  
Tanja Saxell
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Unintended Consequences

scholarly journals Health Informatics in Developing Countries: A Review of Unintended Consequences of IT Implementations, as They Affect Patient Safety and Recommendations on How to Address Them

2016 ◽  
Vol 25 (01) ◽  
pp. 70-72 ◽  
Author(s):  
A. Almerares ◽  
D. Luna ◽  
A. Marcelo ◽  
M. Househ ◽  
H. Mandirola ◽  
...  
Keyword(s):  
Information Technology ◽  
Developing Countries ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Health Informatics ◽  
Healthcare Organization ◽  
Unintended Consequences ◽  
Alert Fatigue ◽  
Available Information

SummaryBackground: Patient safety concerns every healthcare organization. Adoption of Health information technology (HIT) appears to have the potential to address this issue, however unanticipated and undesirable consequences from implementing HIT could lead to new and more complex hazards. This could be particularly problematic in developing countries, where regulations, policies and implementations are few, less standandarized and in some cases almost non-existing.Methods: Based on the available information and our own experience, we conducted a review of unintended consequences of HIT implementations, as they affect patient safety in developing countries.Results: We found that user dependency on the system, alert fatigue, less communications among healthcare actors and workarounds topics should be prioritize. Institution should consider existing knowledge, learn from other experiences and model their implementations to avoid known consequences. We also recommend that they monitor and communicate their own efforts to expand knowledge in the region.

scholarly journals A Survey of the Literature on Unintended Consequences Associated with Health Information Technology: 2014–2015

2016 ◽  
Vol 25 (01) ◽  
pp. 13-29 ◽  
Author(s):  
J. Abraham ◽  
L. L. Novak ◽  
T. L. Reynolds ◽  
A. Gettinger ◽  
K. Zheng
Keyword(s):  
Information Technology ◽  
Time Series ◽  
Health Information Technology ◽  
Health Information ◽  
Unintended Consequences ◽  
Adverse Outcomes ◽  
Future Research ◽  
Health It ◽  
Recorded Data ◽  
The Impact

SummaryObjective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.

scholarly journals Are We There Yet? Human Factors Knowledge and Health Information Technology – the Challenges of Implementation and Impact

2017 ◽  
Vol 26 (01) ◽  
pp. 84-91 ◽  
Author(s):  
P. Turner ◽  
A. Kushniruk ◽  
C. Nohr
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
System Development ◽  
Evidence Base ◽  
Unintended Consequences ◽  
Active Involvement ◽  
Usability Problems ◽  
Development Life Cycle

Summary Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas. This selective rather than systematic review of recent HF research highlights these key challenges and reflects on their implications on the future impact of HF research on HIT. Results: Research provides evidence of continued poor design, implementation, and usability of HIT, as well as technology-induced errors and unintended consequences. The paper highlights support for: (i) strengthening the evidence base on the benefits of HF approaches; (ii) improving knowledge translation in the implementation of HF approaches during HIT design, implementation, and evaluation; (iii) increasing transparency, governance, and enforcement of HF best practices at all stages of the HIT system development life cycle. Discussion and Conclusion: HF and usability approaches are yet to become embedded as integral components of HIT development, implementation, and impact assessment. As HIT becomes ever-more pervasive including with patients as end-users, there is a need to expand our conceptualisation of the problems to be addressed and the suite of tactics and strategies to be used to calibrate our pro-active involvement in its improvement.

scholarly journals Digital Waste? Unintended Consequences of Health Information Technology

2019 ◽  
Author(s):  
Petri Bockerman ◽  
Mika Kortelainen ◽  
Liisa T. Laine ◽  
Mikko Nurminen ◽  
Tanja Saxell
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Unintended Consequences

scholarly journals Troubled Waters: Navigating Unintended Consequences of Health Information Technology

2016 ◽  
Vol 25 (01) ◽  
pp. 5-6 ◽  
Author(s):  
C. U. Lehmann ◽  
B. Séroussi ◽  
M.-C. Jaulent
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Care Quality ◽  
Unintended Consequences ◽  
Editorial Team ◽  
Special Topic ◽  
Health It ◽  
Great Expectations ◽  
Many Sources

SummaryObjectives: To provide an introduction to the 2016 IMIA Yearbook of Medical Informatics by the editors.Methods: We present a brief overview of the 2016 special topic “Unintended consequences of Health IT: new problems, new solutions”, we review our choice of special topic section editors, and discuss the transitions in the editorial team for next year.Results: This edition of the Yearbook acknowledges the fact that implementation and use of Health Information Technology (HIT) may result in unintended consequences, which may lead to both adverse and sometimes beneficial outcomes. However to date, in the literature, undesired outcomes are emphasized with a focus on the complex causes and the many sources that may generate them. The growing awareness of the importance of HIT’s unintended consequences and their increasing documentation reflect a wider acceptance of HIT by users (more use generating more consequences) and and a new type of users (a shift from early adopters to late adopters and laggards), whith great expectations regarding the improvement of care quality through HIT solutions. Different points of view on new problems and new solutions of unintended consequences of Health IT are presented through the keynote paper, survey papers, and the working group contributions.Conclusions: The regular 2016 issue of the IMIA yearbook focuses on new unintended consequences of Health IT – brought on by wider adoption and different types of users as well as solutions to addressing them.

scholarly journals Unintended consequences of health information technology: A need for biomedical informatics

2010 ◽  
Vol 43 (5) ◽  
pp. 828-830 ◽  
Author(s):  
Elmer V. Bernstam ◽  
William R. Hersh ◽  
Ida Sim ◽  
David Eichmann ◽  
Jonathan C. Silverstein ◽  
...  
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Biomedical Informatics ◽  
Unintended Consequences

scholarly journals Understanding Unintended Consequences and Health Information Technology

2016 ◽  
Vol 25 (01) ◽  
pp. 53-60 ◽  
Author(s):  
R. Randell ◽  
E. M. Borycki ◽  
C. E. Kuziemsky
Keyword(s):  
Information Technology ◽  
Literature Review ◽  
Health Information Technology ◽  
Health Information ◽  
Mixed Methods Research ◽  
Social Issues ◽  
Data Extraction ◽  
Unintended Consequences ◽  
Search Terms ◽  
Model Study

SummaryObjective: No framework exists to identify and study unintended consequences (UICs) with a focus on organizational and social issues (OSIs). To address this shortcoming, we conducted a literature review to develop a framework for considering UICs and health information technology (HIT) from the perspective of OSIs.Methods: A literature review was conducted for the period 2000-2015 using the search terms “unintended consequences” and “health information technology”. 67 papers were screened, of which 18 met inclusion criteria. Data extraction was focused on the types of technologies studied, types of UICs identified, and methods of data collection and analysis used. A thematic analysis was used to identify themes related to UICs.Results: We identified two overarching themes. One was the definition and terminology of how people classify and discuss UICs. Second was OSIs and UICs. For the OSI theme, we also identified four sub-themes: process change and evolution, individual-collaborative interchange, context of use, and approaches to model, study, and understand UICs.Conclusions: While there is a wide body of research on UICs, there is a lack of overall consensus on how they should be classified and reported, limiting our ability to understand the implications of UICs and how to manage them. More mixed-methods research and better proactive identification of UICs remain priorities. Our findings and framework of OSI considerations for studying UICs and HIT extend existing work on HIT and UICs by focusing on organizational and social issues.

scholarly journals Are We There Yet? Human Factors Knowledge and Health Information Technology – the Challenges of Implementation and Impact

2017 ◽  
Vol 26 (01) ◽  
pp. 84-91
Author(s):  
P. Turner ◽  
A. Kushniruk ◽  
C. Nohr
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
System Development ◽  
Evidence Base ◽  
Unintended Consequences ◽  
Active Involvement ◽  
Usability Problems ◽  
Development Life Cycle

Summary Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas. This selective rather than systematic review of recent HF research highlights these key challenges and reflects on their implications on the future impact of HF research on HIT. Results: Research provides evidence of continued poor design, implementation, and usability of HIT, as well as technology-induced errors and unintended consequences. The paper highlights support for: (i) strengthening the evidence base on the benefits of HF approaches; (ii) improving knowledge translation in the implementation of HF approaches during HIT design, implementation, and evaluation; (iii) increasing transparency, governance, and enforcement of HF best practices at all stages of the HIT system development life cycle. Discussion and Conclusion: HF and usability approaches are yet to become embedded as integral components of HIT development, implementation, and impact assessment. As HIT becomes ever-more pervasive including with patients as end-users, there is a need to expand our conceptualisation of the problems to be addressed and the suite of tactics and strategies to be used to calibrate our pro-active involvement in its improvement.

scholarly journals Looking for the Evidence: Value of Health Informatics. Editorial

2013 ◽  
Vol 22 (01) ◽  
pp. 04-06 ◽  
Author(s):  
B. Séroussi ◽  
M.-C. Jaulent ◽  
C.U. Lehmann
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Health Informatics ◽  
Unintended Consequences ◽  
Evidence Based ◽  
Main Theme ◽  
What Works ◽  
Quality And Patient Safety ◽  
Reducing Costs

Summary Objectives: To provide an editorial introduction to the 2013 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors. Methods: A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions. Results: Health information technology (HIT) is currently widely implemented to improve healthcare quality and patient safety while reducing costs. Although these benefits are expected and largely advertised, the evidence for these benefits is still missing. Unintended consequences are often reported and some applications have been shown to be wasteful, harmful, and even fatal. Evidence-based health informatics has been defined as “the conscientious, explicit and judicious use of current best evidence when making decisions about the introduction and operation of information technology in a given health care setting”. The 2013 issue of the IMIA Yearbook highlights important contributions about the significant challenges that arise from the assessment of HIT solutions. Progress towards evidence-based health informatics is identified to elicit what works, what doesn't work, and why. In an environment where resources are limited, budgets lower than in past years, and the need to improve care is becoming ever more pressing, focusing on this topic should guide institutions and providers in the implementation of the best health information technology. Conclusion: This overview of progress and current challenges across the spectrum of the discipline shows many great examples of evidence that have been gathered on the effectiveness of HIT. However, evidence remains limited and a significant work should be conducted to improve the development, testing, and implementation of HIT applications.

scholarly journals Six habits of highly successful health information technology: powerful strategies for design and implementation

2019 ◽  
Vol 26 (10) ◽  
pp. 1109-1114 ◽  
Author(s):  
Jessica M Ray ◽  
Raj M Ratwani ◽  
Christine A Sinsky ◽  
Richard M Frankel ◽  
Mark W Friedberg ◽  
...  
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Information Technologies ◽  
Regulatory Compliance ◽  
Unintended Consequences ◽  
Health Technologies ◽  
Design And Implementation ◽  
Exam Room ◽  
The Right

Abstract Healthcare information technologies are now a routine component of patient–clinician interactions. Originally designed for operational functions including billing and regulatory compliance, these systems have had unintended consequences including increased exam room documentation, divided attention during the visit, and use of scribes to alleviate documentation burdens. In an age in which technology is ubiquitous in everyday life, we must re-envision healthcare technology to support both clinical operations and, above all, the patient–clinician relationship. We present 6 habits for designing user-centered health technologies: (1) put patient care first, (2) assemble a team with the right skills, (3) relentlessly ask WHY, (4) keep it simple, (5) be Darwinian, and (6) don’t lose the forest for the trees. These habits should open dialogues between developers, implementers, end users, and stakeholders, as well as outline a path for better, more usable technology that puts patients and their clinicians back at the center of care.

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