scholarly journals Building Usability Knowledge for Health Information Technology: A Usability-Oriented Analysis of Incident Reports

2019 ◽  
Vol 10 (03) ◽  
pp. 395-408 ◽  
Author(s):  
Romaric Marcilly ◽  
Jessica Schiro ◽  
Marie Catherine Beuscart-Zéphir ◽  
Farah Magrabi
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Safety Issue ◽  
Free Text ◽  
Negative Outcomes ◽  
Safety Issues ◽  
Incident Reports ◽  
Patient Safety Incidents

Background The contribution of usability flaws to patient safety issues is acknowledged but not well-investigated. Free-text descriptions of incident reports may provide useful data to identify the connection between health information technology (HIT) usability flaws and patient safety. Objectives This article examines the feasibility of using incident reports about HIT to learn about the usability flaws that affect patient safety. We posed three questions: (1) To what extent can we gain knowledge about usability issues from incident reports? (2) What types of usability flaws, related usage problems, and negative outcomes are reported in incidents reports? (3) What are the reported usability issues that give rise to patient safety issues? Methods A sample of 359 reports from the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience database was examined. Descriptions of usability flaws, usage problems, and negative outcomes were extracted and categorized. A supplementary analysis was performed on the incidents which contained the full chain going from a usability flaw up to a patient safety issue to identify the usability issues that gave rise to patient safety incidents. Results A total of 249 reports were included. We found that incident reports can provide knowledge about usability flaws, usage problems, and negative outcomes. Thirty-six incidents report how usability flaws affected patient safety (ranging from incidents without consequence, to death) involving electronic patient scales, imaging systems, and HIT for medication management. The most significant class of involved usability flaws is related to the reliability, the understandability, and the availability of the clinical information. Conclusion Incidents reports involving HIT are an exploitable source of information to learn about usability flaws and their effects on patient safety. Results can be used to convince all stakeholders involved in the HIT system lifecycle that usability should be considered seriously to prevent patient safety incidents.

scholarly journals Exploration and Initial Development of Text Classification Models to Identify Health Information Technology Usability-Related Patient Safety Event Reports

2019 ◽  
Vol 10 (03) ◽  
pp. 521-527 ◽  
Author(s):  
Allan Fong ◽  
Tomilayo Komolafe ◽  
Katharine T. Adams ◽  
Arman Cohen ◽  
Jessica L. Howe ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Area Under The Curve ◽  
Support Vector ◽  
Free Text ◽  
Initial Development ◽  
Feature Representations ◽  
Specificity And Sensitivity

Background With the pervasive use of health information technology (HIT) there has been increased concern over the usability and safety of this technology. Identifying HIT usability and safety hazards, mitigating those hazards to prevent patient harm, and using this knowledge to improve future HIT systems are critical to advancing health care. Purpose The purpose of this work is to demonstrate the feasibility of a modeling approach to identify HIT usability-related patient safety events (PSEs) from the free-text of safety reports and the utility of such models for supporting patient safety analysts in their analysis of event data. Methods We evaluated three feature representations (bag-of-words [BOWs], topic modeling, and document embeddings) to classify HIT usability-related PSE reports using 5,911 manually annotated reports. Model results were reviewed with patient safety analysts to gather feedback on their usefulness and integration into workflow. Results The combination of term frequency-inverse document frequency BOWs and document embedding features modeled with support vector machine (SVM) with radial basis function (RBF) had the highest overall precision-recall area under the curve (AUC) and f1-score, 72 and 66%, respectively. Using only document embedding features achieved a similar precision-recall AUC and f1-score performance with the SVM RBF model, 70 and 66%, respectively. Models generally favored specificity and sensitivity over precision. Patient safety analysts found the model results to be useful and offered three suggestions on how it can be integrated into their workflow at the point of report entry, in a visual dashboard layer, and to support data retrievals. Conclusion Text mining and document embeddings can support identification of HIT usability-related PSE reports. The positive feedback received on the HIT usability model shows its potential utility in real-world applications.

scholarly journals Identifying Safety Hazards Associated With Intravenous Vancomycin Through the Analysis of Patient Safety Event Reports

2020 ◽  
pp. 31-47
Author(s):  
Adam Krukas ◽  
Ella Franklin ◽  
Chris Bonk ◽  
Jessica Howe ◽  
Ram Dixit ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Assessment Tool ◽  
Improve Patient Safety ◽  
Close Monitoring ◽  
Safety Hazards ◽  
Safety Issues ◽  
Safety Event

Intravenous (IV) vancomycin is one of the most commonly used antibiotics in U.S. hospitals. There are several complexities associated with IV vancomycin use, including the need to have an accurate patient weight for dosing, to provide close monitoring to ensure appropriate drug levels, to monitor renal function, and to continue delivery of the medication at prescribed intervals. There are numerous healthcare system factors, including workflow processes, policies, health information technology, and clinical knowledge that impact the safe use of IV vancomycin. Past literature has identified several safety hazards associated with IV vancomycin use and there are some proposed solutions. Despite this literature, IV vancomycin–related safety issues persist. We analyzed patient safety event reports describing IV vancomycin–related issues in order to identify where in the medication process these issues were appearing, the type of medication error associated with each report, and general contributing factor themes. Our results demonstrate that recent safety reports are aligned with the issues already identified in the literature, suggesting that improvements discussed in the literature have not translated to clinical practice. Based on our analysis and current literature, we have developed a shareable infographic to improve clinician awareness of the complications and safety hazards associated with IV vancomycin and a self-assessment tool to support identification of opportunities to improve patient safety during IV vancomycin therapy. We also recommend development of clear guidelines to optimize health information technology systems to better support safe IV vancomycin use.

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.

Health Information Technology

2015 ◽  
pp. 1-22
Author(s):  
Patrick Albert Palmieri ◽  
Lori T. Peterson ◽  
Miguel Noe Ramirez Noeding
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Organizational Development ◽  
Health Information Technology ◽  
Health Information ◽  
Development Strategy ◽  
Financial Viability ◽  
System Failure ◽  
Healthcare Organizations ◽  
Safety Concerns

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.

Responding to health information technology reported safety events: Insights from patient safety event reports

2019 ◽  
Vol 24 (3) ◽  
pp. 118-124 ◽  
Author(s):  
Katharine T Adams ◽  
Tracy C Kim ◽  
Allan Fong ◽  
Jessica L Howe ◽  
Kathryn M Kellogg ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Healthcare Systems ◽  
Healthcare Staff ◽  
Or Education ◽  
Training And Education ◽  
Safety Event ◽  
Policy Information

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.

A comparative review of patient safety initiatives for national health information technology

2013 ◽  
Vol 82 (5) ◽  
pp. e139-e148 ◽  
Author(s):  
Farah Magrabi ◽  
Jos Aarts ◽  
Christian Nohr ◽  
Maureen Baker ◽  
Stuart Harrison ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
National Health ◽  
Comparative Review

scholarly journals Effects of health information technology on patient outcomes: a systematic review

2015 ◽  
Vol 23 (5) ◽  
pp. 1016-1036 ◽  
Author(s):  
Samantha K Brenner ◽  
Rainu Kaushal ◽  
Zachary Grinspan ◽  
Christine Joyce ◽  
Inho Kim ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Health It ◽  
Term Care ◽  
Safety Outcomes

Abstract Objective To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes. Materials and Methods The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient safety outcomes. Results Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1 to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%) studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on direct patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computerized provider order entry. Discussion and Conclusion Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings.

Sign in / Sign up

Export Citation Format

Share Document