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 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 Human Factors for More Usable and Safer Health Information Technology: Where Are We Now and Where do We Go from Here?

2016 ◽  
Vol 25 (01) ◽  
pp. 120-125 ◽  
Author(s):  
C. Nohr ◽  
E. Borycki ◽  
A. Kushniruk
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
System Development ◽  
Unintended Consequences ◽  
Health It ◽  
Healthcare Settings ◽  
It Systems ◽  
Wide Range

SummaryA wide range of human factors approaches have been developed and adapted to healthcare for detecting and mitigating negative unexpected consequences associated with technology in healthcare (i.e. technology-induced errors). However, greater knowledge and wider dissemination of human factors methods is needed to ensure more usable and safer health information technology (IT) systems. Objective: This paper reports on work done by the IMIA Human Factors Working Group and discusses some successful approaches that have been applied in using human factors to mitigate negative unintended consequences of health IT. The paper addresses challenges in bringing human factors approaches into mainstream health IT development. Results: A framework for bringing human factors into the improvement of health IT is described that involves a multi-layered systematic approach to detecting technology-induced errors at all stages of a IT system development life cycle (SDLC). Such an approach has been shown to be needed and can lead to reduced risks associated with the release of health IT systems into live use with mitigation of risks of negative unintended consequences. Conclusion: Negative unintended consequences of the introduction of IT into healthcare (i.e. potential for technology-induced errors) continue to be reported. It is concluded that methods and approaches from the human factors and usability engineering literatures need to be more widely applied, both in the vendor community and in local and regional hospital and healthcare settings. This will require greater efforts at dissemination and knowledge translation, as well as greater interaction between the academic and vendor communities.

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.

Analyzing the Role of Health Information Technology in Global Health Care

2017 ◽  
pp. 694-714
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Global Health ◽  
Patient Care ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care Providers ◽  
Health It ◽  
Design Development ◽  
Global Health Care

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.

Analyzing the Role of Health Information Technology in Global Health Care

2017 ◽  
pp. 287-307 ◽  
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Global Health ◽  
Patient Care ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care Providers ◽  
Health It ◽  
Design Development ◽  
Global Health Care

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.

Two Important Topics for 2012: Electronic Health Records and mHealth

2012 ◽  
Vol 47 (1) ◽  
pp. 62-63 ◽  
Author(s):  
I. Fox Brent ◽  
G. Felkey Bill
Keyword(s):  
Information Technology ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Health It ◽  
Time And Space ◽  
Health Records ◽  
Electronic Health

As the new year begins, we like to reflect on where health information technology (IT) has been and where it is going. We are not fond of rehashing the minutia regarding every event that occurred in the health IT domain, so we will not spend our time and space presenting an exhaustive review. We will, however, touch on the continuing efforts surrounding electronic health records (EHRs). We will also focus forward in discussing an emerging area that we are closely following.

scholarly journals Managing the patient safety risks of bottom-up health information technology innovations: Recommendations for healthcare providers

2018 ◽  
Vol 25 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Mark A. Sujan
Keyword(s):  
Information Technology ◽  
Risk Management ◽  
Health Information Technology ◽  
Health Information ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Local Health ◽  
Health It ◽  
Bottom Up ◽  
Patients At Risk

Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care. Many healthcare professionals are already improving services through the development of numerous bottom-up local health IT innovations. Such innovations from the ground up are to be welcomed, but healthcare providers are struggling to develop processes for managing the risks that come with the introduction of health IT into clinical processes. I argue that too often the main strategy appears to be one of organisational ignorance. This puts patients at risk, and it threatens the successful adoption of health IT. I recommend that healthcare providers focus on strengthening their processes for organisational learning, promoting proactive risk management strategies, and making risk management decisions transparent and explicit.

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.

Health Information Technology and the Idea of Informed Consent

2010 ◽  
Vol 38 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Melissa M. Goldstein
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Informed Consent ◽  
Health Information Technology ◽  
Health Information ◽  
Information Exchange ◽  
Health Care Quality ◽  
Early Stage ◽  
Care Quality ◽  
Health Care Environment

As policy makers place great hope in health information technology (HIT) as a means to lower costs and achieve improvements in health care quality, safety, and efficiency, organizations at the forefront of building health information exchange (HIE) networks attempt to weave the concept and function of informed consent into an evolving information-driven health care system. The vast amount of information that will become available to both health professionals and patients in the new HIT-driven environment can reasonably be expected to affect the relationship between them in many ways, particularly in the area of informed consent. During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent’s proper role in a heretofore unknown health care environment — one in which electronic information sharing holds primary (and possibly rightful) importance. The central and largely unexamined question of whether and how the legal and ethical underpinnings of informed consent will fit into the context of HITenabled treatment is critical to both public policy and clinical practice.

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