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Yearb Med Inform 2016; 25(01): 13-29
DOI: 10.15265/IY-2016-036
IMIA and Schattauer GmbH
Georg Thieme Verlag KG Stuttgart

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

K. Zheng
1   Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, USA
,
J. Abraham
2   Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
,
L. L. Novak
3   Department of Biomedical Informatics, School of Medicine, Vanderbilt University, Nashville, TN, USA
,
T. L. Reynolds
4   School of Information, University of Michigan, Ann Arbor, MI, USA
,
A. Gettinger
5   Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services, Washington DC, USA
› Author Affiliations
Further Information

Publication History

10 November 2016

Publication Date:
06 March 2018 (online)

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Summary

Objective: 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.

Keywords

Unintended consequences - health information technology - patient safety - electronic health records - medical order entry systems - Health Information Technology for Economic and Clinical Health Act
 

  • References

  • 1 Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc 2004; 11 (02) 104-12.
    PubMedGoogle Scholar
  • 2 Bloomrosen M, Starren J, Lorenzi NM, Ash JS, Patel VL, Shortliffe EH. Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting. J Am Med Inform Assoc 2011; 18 (01) 82-90.
    CrossrefPubMedGoogle Scholar
  • 3 Palmieri PA, Peterson LT, Ford EW. Technological iatrogenesis: new risks force heightened management awareness. J Healthc Risk Manag 2007; 27 (04) 19-24.
    PubMedGoogle Scholar
  • 4 Weiner JP, Kfuri T, Chan K, Fowles JB. “e-iatro-genesis”: the most critical unintended consequence of CPOE and other HIT. J Am Med Inform Assoc 2007; 14 (03) 387-8 discussion 389.
    CrossrefPubMedGoogle Scholar
  • 5 Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE. et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA 2005; 293 (10) 1197-203.
    CrossrefPubMedGoogle Scholar
  • 6 Han YY, Carcillo JA, Venkataraman ST, Clark RS, Watson RS, Nguyen TC. et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics 2005; 116 (06) 1506-12.
    CrossrefPubMedGoogle Scholar
  • 7 Poissant L, Pereira J, Tamblyn R, Kawasumi Y. The impact of electronic health records on time efficiency of physicians and nurses: a systematic review. J Am Med Inform Assoc 2005; 12 (05) 505-16.
    CrossrefPubMedGoogle Scholar
  • 8 Woolhandler S, Himmelstein DU. Administrative work consumes one-sixth of U.S. physicians’ working hours and lowers their career satisfaction. Int J Health Serv 2014; 44 (04) 635-42.
    CrossrefPubMedGoogle Scholar
  • 9 Campbell EM, Sittig DF, Ash JS, Guappone KP, Dykstra RH. Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc 2006; 13 (05) 547-56.
    CrossrefPubMedGoogle Scholar
  • 10 Ash JS, Sittig DF, Poon EG, Guappone K, Campbell E, Dykstra RH. The extent and importance of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc 2007; 14 (04) 415-23.
    CrossrefPubMedGoogle Scholar
  • 11 Koppel R, Wetterneck T, Telles JL, Karsh BT. Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety. J Am Med Inform Assoc 2008; 15 (04) 408-23.
    CrossrefPubMedGoogle Scholar
  • 12 IOM (Institute of Medicine). Health IT and Patient Safety: Building Safer Systems for Better Care. Washington, DC: The National Academies Press; 2012
    Google Scholar
  • 13 Jones SS, Koppel R, Ridgely MS, Palen TE, Wu S, Harrison MI. Guide to Reducing Unintended Consequences of Electronic Health Records. (Prepared by RAND Corporation under Contract No. HHSA290200600017I, Task Order #5). AHRQ Publication No. 11-0105-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2011
    Google Scholar
  • 14 Engle Jr RL. Attempts to use computers as diagnostic aids in medical decision making: A thirty-year experience. Perspect Biol Med 1992; 35 (02) 207-19.
    CrossrefPubMedGoogle Scholar
  • 15 Miller RA. Medical diagnostic decision support systems—past, present, and future: A threaded bibliography and brief commentary. J Am Med Inform Assoc 1994; 1 (01) 8-27.
    CrossrefPubMedGoogle Scholar
  • 16 Berner ES, Detmer DE, Simborg D. Will the wave finally break? A brief view of the adoption of electronic medical records in the United States. J Am Med Inform Assoc. 2005; 12 (01) 3-7.
    PubMedGoogle Scholar
  • 17 Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003; 348 (25) 2526-34.
    CrossrefPubMedGoogle Scholar
  • 18 Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM. et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 15: 1311-6.
    PubMedGoogle Scholar
  • 19 Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr CD, Bates DW. Effects of computerized physician order entry on prescribing practices. Arch Intern Med 2000; 160 (18) 2741-7.
    CrossrefPubMedGoogle Scholar
  • 20 Kohn LT, Corrigan JM, Donaldson MS. editors; Committee on Quality of Health Care in America; Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: The National Academies Press; 2000
    Google Scholar
  • 21 IOM (Institute of Medicine).. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press; 2011
    Google Scholar
  • 22 Executive Order: Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator. http://georgewbush-whitehouse.archives.gov/news/releases/2004/04/20040427-4.html ; accessed January 24, 2016
    PubMedGoogle Scholar
  • 23 Girosi F, Meili R, Scoville R. Extrapolating Evidence of Health Information Technology Savings and Costs. The RAND Corporation; 2005
    Google Scholar
  • 24 Hillestad R, Bigelow J, Bower A, Girosi F, Meili R, Scoville R. et al. Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Aff (Millwood) 2005; 24 (05) 1103-17.
    CrossrefPubMedGoogle Scholar
  • 25 World Health Assembly.. Resolutions and Decisions: WHA58.28 eHealth. http://www.who.int/healthacademy/media/WHA58-28-en.pdf?ua=1; accessed January 25, 2016
    PubMedGoogle Scholar
  • 26 Massaro TA. Introducing physician order entry at a major academic medical center: I. Impact on organizational culture and behavior. Acad Med 1993; 68 (01) 20-5.
    CrossrefPubMedGoogle Scholar
  • 27 Montgomery AA, Fahey T, Peters TJ, MacIntosh C, Sharp DJ. Evaluation of computer based clinical decision support system and risk chart for management of hypertension in primary care: randomised controlled trial. BMJ 2000; 320 7236 686-90.
    CrossrefPubMedGoogle Scholar
  • 28 Goldstein MK, Hoffman BB, Coleman RW, Tu SW, Shankar RD, O’Connor M. et al. Patient safety in guideline-based decision support for hypertension management: ATHENA DSS. J Am Med Inform Assoc 2002; 9 6 Suppl 1 s11-s16.
    CrossrefPubMedGoogle Scholar
  • 29 Harrington L, Kennerly D, Johnson C. Safety issues related to the electronic medical record (EMR): synthesis of the literature from the last decade, 2000–2009. J Healthc Manag 2011; 56 (01) 31-43 ; discussion 43–4.
    PubMedGoogle Scholar
  • 30 Longhurst C, Sharek P, Hahn J, Sullivan J, Classen D. Perceived increase in mortality after process and policy changes implemented with computerized physician order entry. Pediatrics 2006; 117 (04) 1450-1.
    PubMedGoogle Scholar
  • 31 Sittig DF, Ash JS, Zhang J, Osheroff JA, Shabot MM. Lessons from “Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system”. Pediatrics 2006; 118 (02) 797-801.
    CrossrefPubMedGoogle Scholar
  • 32 Ash JS, Sittig DF, Dykstra RH, Guappone K, Carpenter JD, Seshadri V. Categorizing the unintended sociotechnical consequences of computerized provider order entry. Int J Med Inform 2007; 76 (01) S21-7.
    CrossrefPubMedGoogle Scholar
  • 33 Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care—an interactive sociotechnical analysis. J Am Med Inform Assoc 2007; 14 (05) 542-9.
    CrossrefPubMedGoogle Scholar
  • 34 Sittig DF, Ash JS, Guappone KP, Campbell EM, Dykstra RH. Assessing the anticipated consequences of Computer-based Provider Order Entry at three community hospitals using an open-ended, semi-structured survey instrument. Int J Med Inform 2008; 77 (07) 440-7.
    CrossrefPubMedGoogle Scholar
  • 35 Campbell EM, Guappone KP, Sittig DF, Dykstra RH, Ash JS. Computerized provider order entry adoption: implications for clinical workflow. J Gen Intern Med 2009; 24 (01) 21-6.
    CrossrefPubMedGoogle Scholar
  • 36 Ash JS, Sittig DF, Dykstra R, Campbell E, Guappone K. The unintended consequences of computerized provider order entry: findings from a mixed methods exploration. Int J Med Inform 2009; 78 (01) S69-76.
    CrossrefPubMedGoogle Scholar
  • 37 Pirnejad H, Bal R, Shahsavar N. The nature of unintended effects of health information systems concerning patient safety: a systematic review with thematic synthesis. Stud Health Technol Inform 2010; 160 Pt (01) 719-23.
    PubMedGoogle Scholar
  • 38 Carling CL, Kirkehei I, Dalsbø TK, Paulsen E. Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care—a systematic review. BMC Med Inform Decis Mak 2013; 13: 133.
    CrossrefPubMedGoogle Scholar
  • 39 Voshall B, Piscotty R, Lawrence J, Targosz M. Barcode medication administration work-arounds: a systematic review and implications for nurse executives. J Nurs Adm 2013; 43 (10) 530-5.
    CrossrefPubMedGoogle Scholar
  • 40 Gephart S, Carrington JM, Finley B. A systematic review of nurses’ experiences with unintended consequences when using the electronic health record. Nurs Adm Q 2015; 39 (04) 345-56.
    CrossrefPubMedGoogle Scholar
  • 41 Marcilly R, Ammenwerth E, Roehrer E, Pelayo S, Vasseur F, Beuscart-Zéphir MC. Usability flaws in medication alerting systems: impact on usage and work system. Yearb Med Inform 2015; 10 (01) 55-67.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Intern Med 2003; 163 (12) 1409-16.
    CrossrefPubMedGoogle Scholar
  • 43 Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E. et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med 2006; 144 (10) 742-52.
    CrossrefPubMedGoogle Scholar
  • 44 Shekelle PG, Morton SC, Keeler EB. Costs and benefits of health information technology. Evid Rep Technol Assess (Full Rep) 2006; (132) 1-71.
    PubMedGoogle Scholar
  • 45 Shebl NA, Franklin BD, Barber N. Clinical decision support systems and antibiotic use. Pharm World Sci 2007; 29 (04) 342-9.
    CrossrefPubMedGoogle Scholar
  • 46 Eslami S, Abu-Hanna A, de Keizer NF. Evaluation of outpatient computerized physician medication order entry systems: a systematic review. J Am Med Inform Assoc 2007; 14 (04) 400-6.
    CrossrefPubMedGoogle Scholar
  • 47 Eslami S, de Keizer NF, Abu-Hanna A. The impact of computerized physician medication order entry in hospitalized patients—a systematic review. Int J Med Inform 2008; 77 (06) 365-76.
    CrossrefPubMedGoogle Scholar
  • 48 Wolfstadt JI, Gurwitz JH, Field TS, Lee M, Kalkar S, Wu W. et al. The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: A systematic review. J Gen Intern Med 2008; 23 (04) 451-8.
    CrossrefPubMedGoogle Scholar
  • 49 Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. J Am Med Inform Assoc 2008; 15 (05) 585-600.
    CrossrefPubMedGoogle Scholar
  • 50 Yourman L, Concato J, Agostini JV. Use of computer decision support interventions to improve medication prescribing in older adults: a systematic review. Am J Geriatr Pharmacother 2008; 6 (02) 119-29.
    CrossrefPubMedGoogle Scholar
  • 51 Bryan C, Boren SA. The use and effectiveness of electronic clinical decision support tools in the ambulatory/primary care setting: a systematic review of the literature. Inform Prim Care 2008; 16 (02) 79-91.
    PubMedGoogle Scholar
  • 52 Irani JS, Middleton JL, Marfatia R, Omana ET, D’Amico F. The use of electronic health records in the exam room and patient satisfaction: a systematic review. J Am Board Fam Med 2009; 22 (05) 553-62.
    CrossrefPubMedGoogle Scholar
  • 53 Schedlbauer A, Prasad V, Mulvaney C, Phansalkar S, Stanton W, Bates DW. et al. What evidence supports the use of computerized alerts and prompts to improve clinicians’ prescribing behavior?. J Am Med Inform Assoc 2009; 16 (04) 531-8.
    CrossrefPubMedGoogle Scholar
  • 54 Reckmann MH, Westbrook JI, Koh Y, Lo C, Day RO. Does computerized provider order entry reduce prescribing errors for hospital inpatients? A systematic review. J Am Med Inform Assoc 2009; 16 (05) 613-23.
    CrossrefPubMedGoogle Scholar
  • 55 Mack EH, Wheeler DS, Embi PJ. Clinical decision support systems in the pediatric intensive care unit. Pediatr Crit Care Med 2009; 10 (01) 23-8.
    CrossrefPubMedGoogle Scholar
  • 56 Bosman RJ. Impact of computerized information systems on workload in operating room and intensive care unit. Best Pract Res Clin Anaesthesiol 2009; 23 (01) 15-26.
    CrossrefPubMedGoogle Scholar
  • 57 Mador RL, Shaw NT. The impact of a Critical Care Information System (CCIS) on time spent charting and in direct patient care by staff in the ICU: a review of the literature. Int J Med Inform 2009; 78 (07) 435-45.
    CrossrefPubMedGoogle Scholar
  • 58 van Rosse F, Maat B, Rademaker CM, van Vught AJ, Egberts AC, Bollen CW. The effect of computerized physician order entry on medication prescription errors and clinical outcome in pediatric and intensive care: A systematic review. Pediatrics 2009; 123 (04) 1184-90.
    CrossrefPubMedGoogle Scholar
  • 59 Pearson SA, Moxey A, Robertson J, Hains I, Williamson M, Reeve J. et al. Do computerised clinical decision support systems for prescribing change practice? A systematic review of the literature (1990–2007). BMC Health Serv Res 2009; 9: 154.
    CrossrefPubMedGoogle Scholar
  • 60 Vaziri A, Connor E, Shepherd I, Jones RT, Chan T, de Lusignan S. Are we setting about improving the safety of computerised prescribing in the right way? A workshop report. Inform Prim Care 2009; 17 (03) 175-82.
    PubMedGoogle Scholar
  • 61 Hayward GL, Parnes AJ, Simon SR. Using health information technology to improve drug monitoring: a systematic review. Pharmacoepidemiol Drug Saf 2009; 18 (12) 1232-7.
    CrossrefPubMedGoogle Scholar
  • 62 Goldzweig CL, Towfigh A, Maglione M, Shekelle PG. Costs and benefits of health information technology: new trends from the literature. Health Aff (Millwood) 2009; 28 (02) w282-93.
    CrossrefPubMedGoogle Scholar
  • 63 Niazkhani Z, Pirnejad H, Berg M, Aarts J. The impact of computerized provider order entry systems on inpatient clinical workflow: a literature review. J Am Med Inform Assoc 2009; 16 (04) 539-49.
    CrossrefPubMedGoogle Scholar
  • 64 Weir CR, Staggers N, Phansalkar S. The state of the evidence for computerized provider order entry: a systematic review and analysis of the quality of the literature. Int J Med Inform 2009; 78 (06) 365-74.
    CrossrefPubMedGoogle Scholar
  • 65 Jamal A, McKenzie K, Clark M. The impact of health information technology on the quality of medical and health care: a systematic review. HIM J 2009; 38 (03) 26-37.
    CrossrefPubMedGoogle Scholar
  • 66 Berner ES. Clinical Decision Support Systems: State of the Art. AHRQ Publication No. 09-0069-EF. Rockville, Maryland: Agency for Healthcare Research and Quality; June 2009
    Google Scholar
  • 67 Moxey A, Robertson J, Newby D, Hains I, Williamson M, Pearson SA. Computerized clinical decision support for prescribing: provision does not guarantee uptake. J Am Med Inform Assoc 2010; 17 (01) 25-33.
    CrossrefPubMedGoogle Scholar
  • 68 Edwards A, Hollin I, Barry J, Kachnowski S. Barriers to cross-institutional health information exchange: a literature review. J Healthc Inf Manag 2010; 24 (03) 22-34.
    PubMedGoogle Scholar
  • 69 Minard JP, Turcotte SE, Lougheed MD. Asthma electronic medical records in primary care: an integrative review. J Asthma 2010; 47 (08) 895-912.
    CrossrefPubMedGoogle Scholar
  • 70 Robertson J, Walkom E, Pearson SA, Hains I, Williamsone M, Newby D. The impact of pharmacy computerised clinical decision support on prescribing, clinical and patient outcomes: a systematic review of the literature. Int J Pharm Pract 2010; 18 (02) 69-87.
    CrossrefPubMedGoogle Scholar
  • 71 Main C, Moxham T, Wyatt JC, Kay J, Anderson R, Stein K. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: systematic reviews of the effects and cost-effectiveness of systems. Health Technol Assess 2010; 14 (48) 1-227.
    CrossrefPubMedGoogle Scholar
  • 72 Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. J Am Board Fam Med 2010; 23 (05) 655-70.
    CrossrefPubMedGoogle Scholar
  • 73 Shojania KG, Jennings A, Mayhew A, Ramsay C, Eccles M, Grimshaw J. Effect of point-of-care computer reminders on physician behaviour: A systematic review. CMAJ 2010; 182 (05) E216-25.
    CrossrefPubMedGoogle Scholar
  • 74 Black AD, Car J, Pagliari C, Anandan C, Cresswell K, Bokun T. et al. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med 2011; 8 (01) e1000387.
    CrossrefPubMedGoogle Scholar
  • 75 Sahota N, Lloyd R, Ramakrishna A, Mackay JA, Prorok JC, Weise-Kelly L. et al; CCDSS Systematic Review Team. Computerized clinical decision support systems for acute care management: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes. Implement Sci 2011; 6: 91.
    CrossrefPubMedGoogle Scholar
  • 76 Holroyd-Leduc JM, Lorenzetti D, Straus SE, Sykes L, Quan H. The impact of the electronic medical record on structure, process, and outcomes within primary care: a systematic review of the evidence. J Am Med Inform Assoc 2011; 18 (06) 732-7.
    CrossrefPubMedGoogle Scholar
  • 77 Roshanov PS, You JJ, Dhaliwal J, Koff D, Mackay JA, Weise-Kelly L. et al; CCDSS Systematic Review Team. Can computerized clinical decision support systems improve practitioners’ diagnostic test ordering behavior? A decision-maker-researcher partnership systematic review. Implement Sci 2011; 6: 88.
    CrossrefPubMedGoogle Scholar
  • 78 Handel DA, Wears RL, Nathanson LA, Pines JM. Using information technology to improve the quality and safety of emergency care. Acad Emerg Med 2011; 18 (06) e45-51.
    CrossrefPubMedGoogle Scholar
  • 79 McKibbon KA, Lokker C, Handler SM, Dolovich LR, Holbrook AM, O’Reilly D. et al. Enabling Medication Management Through Health Information Technology. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011
    Google Scholar
  • 80 Tawadrous D, Shariff SZ, Haynes RB, Iansavichus AV, Jain AK, Garg AX. Use of clinical decision support systems for kidney-related drug prescribing: a systematic review. Am J Kidney Dis 2011; 58 (06) 903-14.
    PubMedGoogle Scholar
  • 81 Maslove DM, Rizk N, Lowe HJ. Computerized physician order entry in the critical care environment: a review of current literature. J Intensive Care Med 2011; 26 (03) 165-71.
    CrossrefPubMedGoogle Scholar
  • 82 Nguyen L, Bellucci E, Nguyen LT. Electronic health records implementation: an evaluation of information system impact and contingency factors. Int J Med Inform 2014; 83 (11) 779-96.
    CrossrefPubMedGoogle Scholar
  • 83 Lau F, Price M, Boyd J, Partridge C, Bell H, Ra-worth R. Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Med Inform Decis Mak 2012; 12: 10.
    CrossrefPubMedGoogle Scholar
  • 84 Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux RR. et al. Effect of clinical decision-support systems: a systematic review. Ann Intern Med 2012; 157 (01) 29-43.
    CrossrefPubMedGoogle Scholar
  • 85 Cresswell K, Majeed A, Bates DW, Sheikh A. Computerised decision support systems for healthcare professionals: an interpretative review. Inform Prim Care 2012; 20 (02) 115-28.
    PubMedGoogle Scholar
  • 86 Kazmi Z. Effects of exam room EHR use on doctor-patient communication: a systematic literature review. Inform Prim Care 2013; 21 (01) 30-9.
    PubMedGoogle Scholar
  • 87 Baer HJ, Cho I, Walmer RA, Bain PA, Bates DW. Using electronic health records to address overweight and obesity: a systematic review. Am J Prev Med 2013; 45 (04) 494-500.
    CrossrefPubMedGoogle Scholar
  • 88 Goldzweig CL, Orshansky G, Paige NM, Towfigh AA, Haggstrom DA, Miake-Lye I. et al. Electronic patient portals: evidence on health outcomes, satisfaction, efficiency, and attitudes: a systematic review. Ann Intern Med 2013; 159 (10) 677-87.
    CrossrefPubMedGoogle Scholar
  • 89 Smith AJ, Skow Á, Bodurtha J, Kinra S. Health information technology in screening and treatment of child obesity: a systematic review. Pediatrics 2013; 131 (03) e894-902.
    CrossrefPubMedGoogle Scholar
  • 90 Georgiou A, Prgomet M, Paoloni R, Creswick N, Hordern A, Walter S. et al. The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature. Ann Emerg Med 2013; 61 (06) 644-53. e16.
    CrossrefPubMedGoogle Scholar
  • 91 Liu J, Luo L, Zhang R, Huang T. Patient satisfaction with electronic medical/health record: a systematic review. Scand J Caring Sci 2013; 27 (04) 785-91.
    CrossrefPubMedGoogle Scholar
  • 92 Lainer M, Mann E, Sönnichsen A. Information technology interventions to improve medication safety in primary care: a systematic review. Int J Qual Health Care 2013; 25 (05) 590-8.
    CrossrefPubMedGoogle Scholar
  • 93 Nuckols TK, Smith-Spangler C, Morton SC, Asch SM, Patel VM, Anderson LJ. et al. The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis. Syst Rev 2014; 3: 56.
    CrossrefPubMedGoogle Scholar
  • 94 Boyle R, Solberg L, Fiore M. Use of electronic health records to support smoking cessation. Cochrane Database Syst Rev 2014; 12: CD008743.
    PubMedGoogle Scholar
  • 95 Rudin RS, Motala A, Goldzweig CL, Shekelle PG. Usage and effect of health information exchange: a systematic review. Ann Intern Med 2014; 161 (11) 803-11.
    CrossrefPubMedGoogle Scholar
  • 96 Fasola G, Macerelli M, Follador A, Rihawi K, Aprile G, Della Mea V. Health information technology in oncology practice: a literature review. Cancer Inform 2014; 13: 131-9.
    PubMedGoogle Scholar
  • 97 Ranji SR, Rennke S, Wachter RM. Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review. BMJ Qual Saf 2014; 23 (09) 773-80.
    CrossrefPubMedGoogle Scholar
  • 98 Rahurkar S, Vest JR, Menachemi N. Despite the spread of health information exchange, there is little evidence of its impact on cost, use, and quality of care. Health Aff (Millwood) 2015; 34 (03) 477-83.
    CrossrefPubMedGoogle Scholar
  • 99 Vimalananda VG, Gupte G, Seraj SM, Orlander J, Berlowitz D, Fincke BG. et al. Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis. J Telemed Telecare 2015; 21 (06) 323-30.
    CrossrefPubMedGoogle Scholar
  • 100 Rubbo B, Fitzpatrick NK, Denaxas S, Daskalopoulou M, Yu N, Patel RS, UK Biobank Follow-up and Outcomes Working Group, Hemingway H. Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: a systematic review and recommendations. Int J Cardiol 2015; 187: 705-11.
    CrossrefPubMedGoogle Scholar
  • 101 Campanella P, Lovato E, Marone C, Fallacara L, Mancuso A, Ricciardi W. et al. The impact of electronic health records on healthcare quality: a systematic review and meta-analysis. Eur J Public Health 2015; pii: ckv122.
    PubMedGoogle Scholar
  • 102 Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff (Millwood) 2011; 30 (03) 464-71.
    CrossrefPubMedGoogle Scholar
  • 103 Georgiou A, Prgomet M, Markewycz A, Adams E, Westbrook JI. The impact of computerized provider order entry systems on medical-imaging services: a systematic review. J Am Med Inform Assoc 2011; 18 (03) 335-40.
    CrossrefPubMedGoogle Scholar
  • 104 Shekelle PG, Jones SS, Rudin BS, Shanman R, Timmer M, Perry TR. et al. Health Information Technology: An Updated Systematic Review with a Focus on Meaningful Use Functionalities. (Prepared by the Southern California-RAND Evidence-based Practice Center under Contract No. HHSP23337020T). Office of the National Coordinator for Health Information Technology. Washington, D.C.: 2014
    Google Scholar
  • 105 Jones SS, Rudin RS, Perry T, Shekelle PG. Health information technology: an updated systematic review with a focus on meaningful use. Ann Intern Med 2014; 160 (01) 48-54.
    PubMedGoogle Scholar
  • 106 Kellermann AL, Jones SS. What it will take to achieve the as-yet-unfulfilled promises of health information technology. Health Aff (Millwood) 2013; 32 (01) 63-8.
    CrossrefPubMedGoogle Scholar
  • 107 Schildcrout JS, Shi Y, Danciu I, Bowton E, Field JR, Pulley JM. et al. A prognostic model based on readily available clinical data enriched a pre-emptive pharmacogenetic testing program. J Clin Epidemiol 2016; Apr 72: 107-15.
    CrossrefPubMedGoogle Scholar
  • 108 Hanauer DA, Mei Q, Law J, Khanna R, Zheng K. Supporting information retrieval from electronic health records: a report of University of Michigan’s nine-year experience in developing and using the Electronic Medical Record Search Engine (EMERSE). J Biomed Inform 2015; 55: 290-300.
    CrossrefPubMedGoogle Scholar
  • 109 Mehrabi S, Krishnan A, Sohn S, Roch AM, Schmidt H, Kesterson J. Beesley et al. DEEPEN: A negation detection system for clinical text incorporating dependency relation into NegEx. J Biomed Inform 2015; 54: 213-9.
    CrossrefPubMedGoogle Scholar
  • 110 Lohmann K, Gartner D, Kurze R, Schösler T, Schwald M, Störzinger D. et al. More than just crushing: a prospective pre-post intervention study to reduce drug preparation errors in patients with feeding tubes. J Clin Pharm Ther 2015; 40 (02) 220-5.
    CrossrefPubMedGoogle Scholar
  • 111 Ryan AM, McCullough CM, Shih SC, Wang JJ, Ryan MS, Casalino LP. The intended and unintended consequences of quality improvement interventions for small practices in a community-based electronic health record implementation project. Med Care 2014; 52 (09) 826-32.
    CrossrefPubMedGoogle Scholar
  • 112 Amland RC, Dean BB, Yu H, Ryan H, Orsund T, Hackman JL. et al. computerized clinical decision support to prevent venous thromboembolism among hospitalized patients: proximal outcomes from a multiyear quality improvement project. J Healthc Qual 2015; 37 (04) 221-31.
    CrossrefPubMedGoogle Scholar
  • 113 Sockolow PS, Rogers M, Bowles KH, Hand KE, George J. Challenges and facilitators to nurse use of a guideline-based nursing information system: recommendations for nurse executives. Appl Nurs Res 2014; 27 (01) 25-32.
    CrossrefPubMedGoogle Scholar
  • 114 Pell JM, Cheung D, Jones MA, Cumbler E. Don’t fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. J Am Med Inform Assoc 2014; 21 (06) 1109-12.
    CrossrefPubMedGoogle Scholar
  • 115 Russell RA, Triscari D, Murkowski K, Scanlon MC. Impact of computerized order entry to pharmacy interface on order-infusion pump discrepancies. J Drug Deliv 2015; 2015: 686598.
    PubMedGoogle Scholar
  • 116 Rizzato Lede DA, Benítez SE, Mayan 3rd JC, Smith MI, Baum AJ, Luna DR. et al. Patient safety at transitions of care: use of a compulsory electronic reconciliation tool in an academic hospital. Stud Health Technol Inform 2015; 216: 232-6.
    PubMedGoogle Scholar
  • 117 Overhage JM, Gandhi TK, Hope C, Seger AC, Murray MD, Orav EJ. et al. Ambulatory computerized prescribing and preventable adverse drug events. J Patient Saf 2016; Jun 12 (02) 69-74.
    CrossrefPubMedGoogle Scholar
  • 118 Cresswell KM, Bates DW, Williams R, Morrison Z, Slee A, Coleman J. et al. Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two ‘early adopter’ hospitals. J Am Med Inform Assoc 2014; 21 e2 e194-202.
    CrossrefPubMedGoogle Scholar
  • 119 Nanji KC, Rothschild JM, Boehne JJ, Keohane CA, Ash JS, Poon EG. Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. J Am Med Inform Assoc 2014; 21 (03) 481-6.
    CrossrefPubMedGoogle Scholar
  • 120 Graber ML, Siegal D, Riah H, Johnston D, Kenyon K. Electronic health record-related events in medical malpractice claims. J Patient Saf 2015 [Epub ahead of print].
    PubMedGoogle Scholar
  • 121 Magrabi F, Baker M, Sinha I, Ong MS, Harrison S, Kidd MR. et al. Clinical safety of England’s national programme for IT: a retrospective analysis of all reported safety events 2005 to 2011. Int J Med Inform 2015; 84 (03) 198-206.
    CrossrefPubMedGoogle Scholar
  • 122 Meeks DW, Smith MW, Taylor L, Sittig DF, Scott JM, Singh H. An analysis of electronic health record-related patient safety concerns. J Am Med Inform Assoc 2014; 21 (06) 1053-9.
    CrossrefPubMedGoogle Scholar
  • 123 Risko N, Anderson D, Golden B, Wasil E, Barrueto F, Pimentel L. et al. The impact of electronic health record implementation on emergency physician efficiency and patient throughput. Healthc (Amst) 2014; 2 (03) 201-4.
    PubMedGoogle Scholar
  • 124 Ward MJ, Froehle CM, Hart KW, Collins SP, Lindsell CJ. Transient and sustained changes in operational performance, patient evaluation, and medication administration during electronic health record implementation in the emergency department. Ann Emerg Med 2014; 63 (03) 320-8.
    CrossrefPubMedGoogle Scholar
  • 125 Benda NC, Meadors ML, Zachary Hettinger A, Ratwani RM. Emergency physician task switching increases with the introduction of a commercial electronic health record. Ann Emerg Med 2016; Jun 67 (06) 741-6.
    CrossrefPubMedGoogle Scholar
  • 126 Tall JM, Hurd M, Gifford T. Minimal impact of an electronic medical records system. Am J Emerg Med 2015; 33 (05) 663-6.
    CrossrefPubMedGoogle Scholar
  • 127 MacMillan TE, Slessarev M, Etchells E. eWasted time: Redundant work during hospital admission and discharge. Health Informatics J 2016; 22 (01) 60-6.
    CrossrefPubMedGoogle Scholar
  • 128 Redd TK, Read-Brown S, Choi D, Yackel TR, Tu DC, Chiang MF. Electronic health record impact on productivity and efficiency in an academic pediatric ophthalmology practice. J AAPOS 2014; 18 (06) 584-9.
    CrossrefPubMedGoogle Scholar
  • 129 Sanders DS, Read-Brown S, Tu DC, Lambert WE, Choi D, Almario BM. et al. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing. JAMA Ophthalmol 2014; 132 (05) 586-92.
    CrossrefPubMedGoogle Scholar
  • 130 Georgiou A, Prgomet M, Lymer S, Hordern A, Ridley L, Westbrook J. The Impact of a Health IT changeover on medical imaging department work processes and turnaround times: a mixed method study. Appl Clin Inform 2015; 6 (03) 443-53.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 131 Carayon P, Wetterneck TB, Alyousef B, Brown RL, Cartmill RS, McGuire K. et al. Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit. Int J Med Inform 2015; 84 (08) 578-94.
    CrossrefPubMedGoogle Scholar
  • 132 Victores AJ, Coggins K, Takashima M. Electronic health records and resident workflow: a time-motion study of otolaryngology residents. Laryngoscope 2015; 125 (03) 594-8.
    CrossrefPubMedGoogle Scholar
  • 133 Cifuentes M, Davis M, Fernald D, Gunn R, Dickinson P, Cohen DJ. Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care. J Am Board Fam Med 2015; 28 (01) S63-72.
    CrossrefPubMedGoogle Scholar
  • 134 Lafata JE, Shay LA, Brown R, Street RL. Office-based tools and primary care visit communication, length, and preventive service delivery. Health Serv Res 2016; Apr 51 (02) 728-45.
    CrossrefPubMedGoogle Scholar
  • 135 McLean TA, Lewkowitz AK, Test E, Zlatnik MG. Does an electronic health record improve completeness of prenatal studies?. Appl Clin Inform 2015; 6 (04) 669-76.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 136 Thirukumaran CP, Dolan JG, Reagan Webster P, Panzer RJ, Friedman B. The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures. Health Serv Res 2015; 50 (01) 273-89.
    CrossrefPubMedGoogle Scholar
  • 137 Varpio L, Day K, Elliot-Miller P, King JW, Kuziemsky C, Parush A. et al. The impact of adopting EHRs: how losing connectivity affects clinical reasoning. Med Educ 2015; 49 (05) 476-86.
    CrossrefPubMedGoogle Scholar
  • 138 Melby L, Hellesø R. Introducing electronic messaging in Norwegian healthcare: unintended consequences for interprofessional collaboration. Int J Med Inform 2014; 83 (05) 343-53.
    CrossrefPubMedGoogle Scholar
  • 139 Saddik B, Al-Mansour S. Does CPOE support nurse-physician communication in the medication order process? A nursing perspective. Stud Health Technol Inform 2014; 204: 149-55.
    PubMedGoogle Scholar
  • 140 Ser G, Robertson A, Sheikh A. A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals. PLoS One 2014; 1: e77669.
    PubMedGoogle Scholar
  • 141 Fleming NS, Becker ER, Culler SD, Cheng D, McCorkle R, da Graca B. et al. The impact of electronic health records on workflow and financial measures in primary care practices. Health Serv Res 2014; 49 1 Pt 2 405-20.
    CrossrefPubMedGoogle Scholar
  • 142 Howley MJ, Chou EY, Hansen N, Dalrymple PW. The long-term financial impact of electronic health record implementation. J Am Med Inform Assoc 2015; 22 (02) 443-52.
    CrossrefPubMedGoogle Scholar
  • 143 Hysong SJ, Spitzmuller C, Espadas D, Sittig DF, Singh H. Electronic alerts and clinician turnover: the influence of user acceptance. Am J Manag Care 2014; 20 11 Spec No. 17 SP520-30.
    PubMedGoogle Scholar
  • 144 Crowson MG, Vail C, Eapen RJ. Influence of electronic medical record implementation on provider retirement at a major academic medical centre. J Eval Clin Pract 2016; Apr 22 (02) 222-6.
    CrossrefPubMedGoogle Scholar
  • 145 Campos-Castillo C, Anthony DL. The double-edged sword of electronic health records: implications for patient disclosure. J Am Med Inform Assoc 2015; 22 e1 e130-40.
    CrossrefPubMedGoogle Scholar
  • 146 Carrington JM, Gephart SM, Verran JA, Finley BA. Development of an instrument to measure the unintended consequences of EHRs. West J Nurs Res 2015; 37 (07) 842-58.
    CrossrefPubMedGoogle Scholar
  • 147 Patel VL, Arocha JF, Kushniruk AW. Patients’ and physicians’ understanding of health and biomedical concepts: relationship to the design of EMR systems. J Biomed Inform 2002; 35 (01) 8-16.
    CrossrefPubMedGoogle Scholar
  • 148 Canon SJ, Purifoy JA, Heulitt GM, Hogan W, Swearingen C, Williams M. et al. Results: Survey of pediatric urology electronic medical records-use and perspectives. J Urol 2011; 186 (04) 1740-4.
    CrossrefPubMedGoogle Scholar
  • 149 Novak LL, Anders S, Gadd CS, Lorenzi NM. Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation. J Am Med Inform Assoc 2012; 19 (06) 1043-9.
    CrossrefPubMedGoogle Scholar
  • 150 Health Information Technology Patient Safety Action & Surveillance Plan. Washington, DC: Office of the National Coordinator for Health Information Technology. 2013
    Google Scholar
  • 151 Sittig DF, Singh H. Electronic health records and national patient-safety goals. N Engl J Med 2012; 367 (19) 1854-60.
    CrossrefPubMedGoogle Scholar
  • 152 Magrabi F, Aarts J, Nohr C, Baker M, Harrison S, Pelayo S. Talmon et al. A comparative review of patient safety initiatives for national health information technology. Int J Med Inform 2013; 82 (05) e139-48.
    CrossrefPubMedGoogle Scholar
  • 153 Wallace C, Zimmer KP, Possanza L, Giannini R, Solomon R. How to Identify and Address Unsafe Conditions Associated with Health IT. (Prepared by ECRI Institute under Contract No. HHSP23320095655WC, Task Order HHSP23337003T). Washington, DC: Office of the National Coordinator for Health Information Technology; 2013
    Google Scholar
  • 154 Schneider EC, Ridgely MS, Meeker D, Hunter LE, Khodyakov D, Rudin R. Promoting Patient Safety Through Effective Health Information Technology Risk Management. (Prepared by RAND Corporation under Contract No. HHSP-23320095649WC). Washington, DC: Office of the National Coordinator for Health Information Technology; 2014
    Google Scholar
  • 155 Ratwani R, Hettinger AZ, Fairbanks RJ. The Role of Health IT Developers in Improving Patient Safety in High Reliability Organizations. (Prepared by National Center for Human Factors in Healthcare under Contract No. HHSP23320095655WC, Task Order HHSP23337003T). Washington, DC: Office of the National Coordinator for Health Information Technology; 2014
    Google Scholar
  • 156 Mardon R, Olinger L, Szekendi M, Williams T, Sparnon E, Zimmer K. Health Information Technology Adverse Event Reporting: Analysis of Two Databases. (Prepared by Westat, UHC, and ECRI Institute under Contract Order No. HHSP23337024T). Washington, DC: Office of the National Coordinator for Health Information Technology; 2014
    Google Scholar
  • 157 Castro G, Buczkowski L, Hafner J, Barrett S, Rasinski K, Williams S. Investigations of Health-IT–Related Deaths, Serious Injuries, or Unsafe Conditions. (Prepared by Joint Commission under Contract No. HHSP233201300019C). Washington, DC: Office of the National Coordinator for Health Information Technology; 2015
    Google Scholar
  • 158 SAFER Guides. https://www.healthit.gov/safer/safer-guides; accessed February 1, 2015
    PubMed
  • 159 Lowry SZ, Quinn MT, Ramaiah M, Schumacher RM, Patterson ES, North R. et al. Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records. NISTIR 7804. Washington DC: National Institute of Standards and Technology; 2012
    Google Scholar
  • 160 Lowry SZ, Ramaiah M, Taylor S, Patterson ES, Prettyman SS, Simmons D. et al. Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records: Empirically Based Use Cases for Validating Safety Enhanced Usability and Guidelines for Standardization. NISTIR 7804-1. Washington DC: National Institute of Standards and Technology; 2015
    Google Scholar
  • 161 U.S. Food and Drug Administration. FDASIA Health IT Report Proposed Strategy and Recommendations for a Risk-Based Framework; 2014
    PubMedGoogle Scholar
  • 162 National Quality Forum.. Identification and Prioritization of Health IT Patient Safety Measures. (Prepared under Contract No. HHSM-500-2012-00009I, Task Order HHSM-500-T0016). Washington DC: Department of Health and Human Services; 2016
    Google Scholar
  • 163 Health IT Safety Collaborative. http://www.healthitsafety.org accessed February 1, 2015
    PubMedGoogle Scholar
  • 164 The Partnership for Health IT Patient Safety. https://www.ecri.org/resource-center/Pages/HITPartnership.aspx ; accessed February 1, 2015.
    PubMedGoogle Scholar
  • 165 CHIME National Patient ID Challenge. https://herox.com/PatientIDChallenge ; accessed February 1, 2015.
    PubMedGoogle Scholar
  • 166 Rosenbaum L. Transitional chaos or enduring harm? The EHR and the disruption of medicine. N Engl J Med 2015; 373 (17) 1585-8.
    CrossrefPubMedGoogle Scholar
  • 167 Sittig DF, Classen DC, Singh H. Patient safety goals for the proposed Federal Health Information Technology Safety Center. J Am Med Inform Assoc 2015; 22 (02) 472-8.
    PubMedGoogle Scholar
  • 168 Singh H, Sittig DF. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Qual Saf 2016; Apr 25 (04) 226-32.
    CrossrefPubMedGoogle Scholar
  • 169 Wachter R. The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age. New York: McGraw-Hill; 2015
    Google Scholar