Cited by 269Electronic Health Records SystemsInformation Systems Theories and ImplementationTechnology and Human Factors in Education and Health

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Categorizing the unintended sociotechnical consequences of computerized provider order entry

Ash, Joan S., Sittig, Dean F., Dykstra, Richard H., Guappone, Kenneth, Carpenter, James D., Seshadri, Veena·2007·International Journal of Medical Informatics

DOI 10.1016/j.ijmedinf.2006.05.017

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Abstract

Objective To describe the kinds of unintended consequences related to the implementation of computerized provider order entry (CPOE) in the outpatient setting.Design Ethnographic and interview data were collected by an interdisciplinary team over a 7 month period at four clinics.Measurements Instances of unintended consequences were categorized using an expanded Diffusion of Innovations theory framework.Results The framework was clarified and expanded. There are both desirable and undesirable unintended consequences, and they can be either direct or indirect, but there are also many consequences that are not clearly either desirable or undesirable or may even be both, depending on one's perspective. The undesirable consequences include error and security concerns and issues related to alerts, workflow, ergonomics, interpersonal relations, and reimplementations.Conclusion Consequences of implementing and reimplementing clinical systems are complex. The expanded Diffusion of Innovations theory framework is a useful tool for analyzing such consequences.

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Authors: Ash, J. S., Sittig, D. F., Dykstra, R. H., Guappone, K., Carpenter, J. D., & Seshadri, V.
Affiliations: Oregon Health & Science University (US)
Corresponding author: Ash, Joan S.
ORCID: Ash, Joan S.
Sittig, Dean F.
Venue: International Journal of Medical Informatics
Publisher: Elsevier BV
Published: 2007-06
Volume: 76
Pages: S21-S27
ISSN: 1386-5056 (ISSN-L)
DOI: 10.1016/j.ijmedinf.2006.05.017
OpenAlex: W2004091813
Cited by: 267
References: 19
Citations by year: 2026: 4 · 2025: 4 · 2024: 8 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 6 · 2019: 15 · 2018: 9 · 2017: 18 · 2016: 17 · 2015: 17 · 2014: 18 · 2013: 22 · 2012: 22
FWCI: 33.61
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Medical Informatics (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
U.S. National Library of Medicine (LM06942)
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Social Sciences › Business, Management and Accounting › Management Information Systems › Information Systems Theories and Implementation
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords: computerized physician order entry, unintended consequences, diffusion of innovations, outpatient clinics, clinical workflow, clinical alerts, medical errors, patient safety, human factors, interpersonal relationships, health information technology
MeSH terms: Ambulatory Care, Diffusion of Innovation, Humans, Interviews as Topic, Oregon, Sociology, Medical, Interdisciplinary Communication, Medical Order Entry Systems

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Categorizing the unintended sociotechnical consequences of computerized provider order entry

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