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 ◽  
...  

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.

2013 ◽  
Vol 22 (01) ◽  
pp. 04-06 ◽  
Author(s):  
B. Séroussi ◽  
M.-C. Jaulent ◽  
C.U. Lehmann

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.


2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i28-i28
Author(s):  
N Hassan ◽  
R Slight ◽  
S P Slight

Abstract Introduction Antimicrobial resistance is a global health problem, especially in developing countries. Antimicrobial Stewardship Programmes (AMS) have been shown to be effective at reducing antimicrobial resistance and hospital patient stays. Health information technology (HIT) can support Outpatient Parenteral Antimicrobial Therapy (OPAT) through more accurate diagnosis and management of infectious diseases. Aim To evaluate the knowledge and attitude of Egyptian healthcare professionals towards the application of HIT to optimize OPAT. Methods Healthcare professionals who worked in either private or public sectors of Egyptian healthcare system were emailed and asked if they would be willing to complete an electronic questionnaire (using google forms). One reminder was sent by email each week for two weeks (two in total) from the first invitation. The survey was laid out in four sections. The first section included specific details about the healthcare professional’s current employment and role, the second related to HIT services available in their organisations, the third covered their training in HIT and antimicrobial stewardship programmes, and the fourth included their use of HIT to optimize OPAT. Ethical approval was obtained from National Heart Institute, Egypt. Descriptive analysis was carried out for all the variables. One-way ANOVA testing at level of significance P-value <0.05, was used to compare numerical variables. SPSS version 26 was used for statistical analysis. Results Three hundred and eighty-five healthcare professionals were invited to respond to the questionnaire. (The response rate was 75.34% (290)). Of these, 152 (52.6%) were pharmacists, 134 (46.4%) physicians, and 3 (1%) nurses, and many participants (30.8%) had between 6 to 10 years of experience working in either outpatient or in-patient units. Only 15.2% of respondents mentioned that they have access to OPAT in their organizations, 51.2% did not have the service, while 33.6% responded that they did not know if the service was available. However, 27.3% had a training on ASP and 18.3% had a training on HIT. Mean scores for both knowledge (14.31±5.49) and attitude (14.67±2.53) were significantly higher in professionals who had received training in HIT (p = 0.003 & 0.006 respectively). However, scores for attitude were better than scores for knowledge. Conclusions In developing countries, HIT applications in OPAT are still in their infancy with only a few organisations adopting them. Egyptian healthcare professionals showed positive attitudes towards HIT use, especially when their knowledge was improved through training. Two strengths of this study include our high response rate and the wide breadth of different healthcare professionals who responded from both private and public healthcare settings. However, being a questionnaire, some questions were left unanswered and some respondents may not have been aware of their reasons for a particular answer. That said, this study has important implications for practice, with more awareness amongst healthcare professionals required on the availability of HIT services in their hospitals and how further training may be needed on the applications of HIT in optimizing OPAT.


2015 ◽  
pp. 1-22
Author(s):  
Patrick Albert Palmieri ◽  
Lori T. Peterson ◽  
Miguel Noe Ramirez Noeding

Healthcare organizations are increasingly willing to develop more efficient and higher quality processes to combat the competition and enhance financial viability by adopting contemporary solutions such as Health Information Technology (HIT). However, technological failures occur and represent a contemporary organizational development priority resulting from incongruent organization-technology interfaces. Technologically induced system failure has been defined as technological iatrogenesis. The chapter offers the Healthcare Iatrogenesis Model as an organizational development strategy to guide the responsible implementation of HIT projects. By recognizing the etiology of incongruent organizational interfaces and anticipating patient safety concerns, leaders can proactively respond to system limitations and identify hidden process instabilities prior to costly and consequential catastrophic events.


2019 ◽  
Vol 24 (3) ◽  
pp. 118-124 ◽  
Author(s):  
Katharine T Adams ◽  
Tracy C Kim ◽  
Allan Fong ◽  
Jessica L Howe ◽  
Kathryn M Kellogg ◽  
...  

Objective We analyzed the described resolutions of patient safety event reports related to health information technology to determine how healthcare systems responded to these events, recognizing that certain types of solutions such as training and education have a limited impact. Methods A large database of over 1.7 million patient safety event reports was filtered to include those identified by the reporter as being related to health information technology. The resolution text was manually reviewed and coded into one or more of four categories: No Resolution, Training/Education, Policy, Information Technology-oriented solution. Results Most events (64%) did not include a resolution. Of those that did, Training/Education was the most commonly reported single or component of a multi-pronged solution (55%), followed by Information Technology (45%). Only 59 events (6% of resolutions) described more than one method of resolution. Conclusion Health information technology-related patient safety event resolutions most often described a solution that suggested additional training or education for healthcare staff, despite the recognized limitations of training and education in resolving these events. Few events suggested multiple resolution methods. Ensuring health information technology-related events are resolved and incorporate effective solutions should be a continued focus area for healthcare systems.


2016 ◽  
Vol 25 (01) ◽  
pp. 13-29 ◽  
Author(s):  
J. Abraham ◽  
L. L. Novak ◽  
T. L. Reynolds ◽  
A. Gettinger ◽  
K. Zheng

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.


2020 ◽  
Vol 27 (11) ◽  
pp. 1798-1801 ◽  
Author(s):  
Matthew S Pantell ◽  
Julia Adler-Milstein ◽  
Michael D Wang ◽  
Aric A Prather ◽  
Nancy E Adler ◽  
...  

Abstract As evidence of the associations between social factors and health outcomes continues to mount, capturing and acting on social determinants of health (SDOH) in clinical settings has never been more relevant. Many professional medical organizations have endorsed screening for SDOH, and the U.S. Office of the National Coordinator for Health Information Technology has recommended increased capacity of health information technology to integrate and support use of SDOH data in clinical settings. As these efforts begin their translation to practice, a new subfield of health informatics is emerging, focused on the application of information technologies to capture and apply social data in conjunction with health data to advance individual and population health. Developing this dedicated subfield of informatics—which we term social informatics—is important to drive research that informs how to approach the unique data, interoperability, execution, and ethical challenges involved in integrating social and medical care.


Author(s):  
Jon W McKeeby ◽  
Christopher M Siwy ◽  
Josanne Revoir ◽  
Seth D Carlson ◽  
Maria D Joyce ◽  
...  

Abstract Assuring the safety of both patients and healthcare workers (HCWs) in hospitals has been the primary focus of every healthcare organization during the COVID 19 pandemic. This article discusses the NIH Clinical Center’s interdisciplinary approach to deploying an organizational Asymptomatic Staff Testing System.


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