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

Brenner, Samantha K.; Kaushal, Rainu; Grinspan, Zachary M.; Joyce, Christine; Kim, Inho; Allard, Rhonda J.; Delgado, Diana; Abramson, Erika L.

doi:10.1093/jamia/ocv138

Cited by 93 publications

(59 citation statements)

References 101 publications

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“…As was noted above, concerns about whether, and to what extent, HF and usability research is contributing to ensuring safe and usable health technologies, applications, and services require further analysis [30,31]. But as Brenner et al [63] noted in their systematic review exploring links between HIT and patient outcomes, this is perhaps part of a broader problem as 'many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings'. Similarly, Guise et al [64] have identified patient safety risks associated with telecare and recommended greater use of HF and usability approaches.…”

Section: Technology Human Factors and Usability: Old And New Problemsmentioning

confidence: 99%

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

Turner¹,

Kushniruk²,

Nøhr³

2017

Yearb Med Inform

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SummaryObjective: 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 technologyinduced 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. KeywordsHuman factors engineering; usability; patient safety; health information technology Yearb Med Inform 2017:84-91 http://dx

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Section: Technology Human Factors and Usability: Old And New Problemsmentioning

confidence: 99%

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

Turner¹,

Kushniruk²,

Nøhr³

2017

Yearb Med Inform

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“…Though studies predominantly report positive consequences on patient safety parameters when using HIT (e.g., reduction of adverse events), a few studies also report on negative consequences (e.g., increase in mortality due to adverse events) which could have been avoided with thorough implementation and monitoring resulting in lives saved (Han et al, 2005;Brenner et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Understanding Health Information Technologies as Complex Interventions With the Need for Thorough Implementation and Monitoring to Sustain Patient Safety

Wienert

2019

Front. ICT

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“…Improvements in medication safety in paediatric oncology can be achieved by using electronic medication management (EMM) systems (also known as computerized provider order entry—CPOE) with clinical decision support (CDS; Aita et al, ; Bannan & Tully, ; Brenner et al, ; Chen & Lehmann, ; Elsaid, Garguilo, & Collins, ; Maaskant et al, ; Rinke et al, ; van Rosse et al, ; Small, Barrett, & Price, ). This technology has the potential to improve safety by facilitating the scheduling of chemotherapy cycles and associated monitoring tests, calculating cumulative doses of drugs and supporting medication workflows (Allen et al, ; Elsaid et al, ; Gandhi, Tyono, Pasetka, & Trudeau, ; Hoffman, Baker, Howard, Laver, & Shenep, ).…”

Section: Introductionmentioning

confidence: 99%

Medication safety incidents in paediatric oncology after electronic medication management system implementation

et al. 2019

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Objective To explore medication safety issues related to use of an electronic medication management system (EMM) in paediatric oncology practice, through the analysis of patient safety incident reports. Methods We analysed 827 voluntarily reported incidents relating to oncology patients that occurred over an 18‐month period immediately following implementation of an EMM in a paediatric hospital in Australia. We identified medication‐related and EMM‐related incidents and carried out a content analysis to identify patterns. Results We found ~79% (n = 651) of incidents were medication‐related and, of these, ~45% (n = 294) were EMM‐related. Medication‐related incidents included issues with: prescribing; dispensing; administration; patient transfers; missing chemotherapy protocols and information on current stage of patient treatment; coordination of chemotherapy administration; handling or storing medications; children or families handling medications. EMM‐related incidents were classified into four groups: technical issues, issues with the user experience, unanticipated problems in EMM workflow, and missing safety features. Conclusions Incidents reflected difficulties with managing therapies rich in interdependencies. EMM, and especially its ‘automaticity’, contributed to these incidents. As EMM impacts on safety in such high‐risk settings, it is essential that users are aware of and attend to EMM automatic behaviours and are equipped to troubleshoot them.

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

Abstract: 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.

Cited by 93 publications

References 101 publications

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

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

Understanding Health Information Technologies as Complex Interventions With the Need for Thorough Implementation and Monitoring to Sustain Patient Safety

Medication safety incidents in paediatric oncology after electronic medication management system implementation

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