Exploring the persistence of paper with the electronic health record
Abstract
Objective Healthcare organizations are increasingly implementing electronic health records (EHRs) and other related health information technology (IT). Even in institutions which have long adopted these computerized systems, employees continue to rely on paper to complete their work. The objective of this study was to explore and understand human-technology integration factors that may be causing employees to rely on paper alternatives to the EHR.Methods We conducted semi-structured interviews with 20 key-informants in a large Veterans Affairs Medical Center (VAMC), with a fully implemented EHR, to understand the use of paper-based alternatives. Participants included clinicians, administrators, and IT specialists across several service areas in the medical center.Results We found 11 distinct categories of paper-based workarounds to the use of the EHR. Paper use related to the following: (1) efficiency; (2) knowledge/skill/ease of use; (3) memory; (4) sensorimotor preferences; (5) awareness; (6) task specificity; (7) task complexity; (8) data organization; (9) longitudinal data processes; (10) trust; and (11) security. We define each of these and provide examples that demonstrate how these categories promoted paper use in spite of a fully implemented EHR.Conclusions In several cases, paper served as an important tool and assisted healthcare employees in their work. In other cases, paper use circumvented the intended EHR design, introduced potential gaps in documentation, and generated possible paths to medical error. We discuss implications of these findings for EHR design and implementation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Paper continues to be used extensively at a large Veterans Affairs Medical Center where EHRs have existed for 10 years.
“The paper persistence problem was recently explored at a large Veterans Affairs Medical Center 84 where EHRs have existed for 10 years. Paper continues to be used extensively.”
From Health information technology: fallacies and sober realities (2010) · cites this paper as [84]
Cites
Kawamoto, K., Houlihan, C. A., Balas, E. A., & Lobach, D. F. (2005) · BMJ · doi:10.1136/bmj.38398.500764.8f · Cited by 2,703 · see citing works
Bates, D. W., Kuperman, G. J., Wang, S., Gandhi, T., Kittler, A., Volk, L., Spurr, C., Khorasani, R., Tanasijevic, M., & Middleton, B. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1370 · Cited by 1,346 · see citing works
Types of Unintended Consequences Related to Computerized Provider Order Entry
Campbell, E. M., Sittig, D. F., Ash, J. S., Guappone, K. P., & Dykstra, R. H. (2006) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2042 · Cited by 823 · see citing works
Medication-related clinical decision support in computerized provider order entry systems: a review
Kuperman, G. J., Bobb, A., Payne, T. H., Avery, A. J., Gandhi, T. K., Burns, G., Classen, D. C., & Bates, D. W. (2007) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2170 · Cited by 763 · see citing works
The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry
Ash, J. S., Sittig, D. F., Poon, E. G., Guappone, K. P., Campbell, E., & Dykstra, R. H. (2007) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2373 · Cited by 500 · see citing works
Patterson, E. S., Cook, R. I., & Render, M. L. (2002) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1061 · Cited by 370 · see citing works
Improving Recognition of Drug Interactions
Glassman, P. A., Simon, B. F., Belperio, P. S., & Lanto, A. B. (2002) · Medical Care · doi:10.1097/00005650-200212000-00004 · Cited by 279 · see citing works
Exploring Barriers and Facilitators to the Use of Computerized Clinical Reminders
Saleem, J. J., Patterson, E. S., Militello, L. G., Render, M. L., Orshansky, G., & Asch, S. M. (2005) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1777 · Cited by 250 · see citing works
Self-citationHow Professionals Make Decisions
Montgomery, H., Lipshitz, R., & Brehmer, B. (2004) · CRC Press eBooks · doi:10.1201/b12472 · Cited by 215 · see citing works
Off the Record — Avoiding the Pitfalls of Going Electronic
Hartzband, P., & Groopman, J. E. (2008) · New England Journal of Medicine · doi:10.1056/nejmp0802221 · Cited by 190 · see citing works
Patterson, E. S., Rogers, M. L., Chapman, R. J., & Render, M. L. (2006) · Human Factors: The Journal of the Human Factors and Ergonomics Society · doi:10.1518/001872006776412234 · Cited by 157 · see citing works
Characteristics and override rates of order checks in a practitioner order entry system.
Payne, T. H., Nichol, W. P., Hoey, P., & Savarino, J. E. (2002) · PubMed Central · Cited by 129 · see citing works
Opportunities for and challenges of computerisation
Powsner, S. M., Wyatt, J. C., & Wright, P. (1998) · The Lancet · doi:10.1016/s0140-6736(98)08309-3 · Cited by 119 · cited 2× · see citing works
“[1] S.”
BackgroundHuman Factors Barriers to the Effective Use of Ten HIV Clinical Reminders
Patterson, E. S., Nguyen, A. D., Halloran, J. P., & Asch, S. M. (2004) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1364 · Cited by 115 · see citing works
Weir, C. R., Nebeker, J. R., Hicken, B. L., Campo, R., Drews, F. A., & LeBar, B. (2006) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2231 · Cited by 110 · see citing works
Lin, C.-P., Payne, T. H., Nichol, W. P., Hoey, P. J., Anderson, C. L., & Gennari, J. H. (2008) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2453 · Cited by 110 · see citing works
Practitioners’ views on computerized drug-drug interaction alerts in the VA system
Ko, Y., Abarca, J., Malone, D. C., Dare, D. C., Geraets, D., Houranieh, A., Jones, W. N., Nichol, W. P., Schepers, G. P., & Wilhardt, M. (2007) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2224 · Cited by 102 · see citing works
(2007) · PubMed · Cited by 93 · see citing works
Clinical Relevance of Automated Drug Alerts From the Perspective of Medical Providers
Spina, J. R., Glassman, P. A., Belperio, P. S., Cader, R., Asch, S. M., & Primary Care Investigative Group of the VA Los Angeles Healthcare System (2005) · American Journal of Medical Quality · doi:10.1177/1062860604273777 · Cited by 64 · see citing works
Exposure to Automated Drug Alerts Over Time
Glassman, P. A., Belperio, P. S., Simon, B. F., Lanto, A. B., & Lee, M. (2006) · Medical Care · doi:10.1097/01.mlr.0000199849.08389.91 · Cited by 55 · see citing works
A Framework for Epistemological Analysis in Empirical (Laboratory and Field) Studies
Xiao, Y., & Vicente, K. J. (2000) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1518/001872000779656642 · Cited by 48 · see citing works
Notes on human performance analysis
Hollnagel, E., Pedersen, O. M., & Rasmussen, J. (1981) · Cited by 41 · see citing works
Varpio, L., Schryer, C. F., Lehoux, P., & Lingard, L. (2006) · Academic Medicine · doi:10.1097/01.acm.0000237699.49711.35 · Cited by 39 · see citing works
Persistent paper: the myth of "going paperless".
(2009) · Europe PMC (PubMed Central) · Cited by 26 · see citing works
Clinical Reminders: Why Don't they use them?
Militello, L. G., Patterson, E. S., Tripp‐Reimer, T., Asch, S. M., Fung, C. H., Glassman, P. A., Anders, S. H., & Doebbeling, B. N. (2004) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/154193120404801505 · Cited by 25 · see citing works
Self-citationThe Chart is Dead—Long Live the Chart
Wears, R. L. (2008) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2008.04.005 · Cited by 23 · see citing works
Semper Gumby sub Rosa : Adaptability in a Healthcare Setting
Wears, R. L., & Perry, S. J. (2008) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/154193120805200426 · Cited by 4 · see citing works
Semper Gumby sub Rosa: Adaptability in a Healthcare Setting
Wears, R. L., & Perry, S. J. (2008) · PsycEXTRA Dataset · doi:10.1037/e578112012-027 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Electronic Health Records: Then, Now, and in the Future
Evans, R. S. (2016) · Yearbook of Medical Informatics · doi:10.15265/iys-2016-s006 · Cited by 816 · see citing works
Nguyen, L., Bellucci, E., & Nguyen, L. T. (2014) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2014.06.011 · Cited by 504 · see citing works
Health information technology: fallacies and sober realities
Karsh, B.-T., Weinger, M. B., Abbott, P. A., & Wears, R. L. (2010) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.2010.005637 · Cited by 365 · see citing works
Nurses’ workarounds in acute healthcare settings: a scoping review
Debono, D. S., Greenfield, D., Travaglia, J., Long, J. C., Black, D. A., Johnson, J. K., & Braithwaite, J. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-175 · Cited by 250 · see citing works
Multi-professional patterns and methods of communication during patient handoffs
Benham-Hutchins, M. M., & Effken, J. A. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2009.12.005 · Cited by 124 · see citing works
Paper persistence, workarounds, and communication breakdowns in computerized consultation management
Saleem, J. J., Russ, A. L., Neddo, A., Blades, P. T., Doebbeling, B. N., & FORESMAN, B. H. (2011) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2011.03.016 · Cited by 110 · see citing works
Self-citationBlijleven, V., Koelemeijer, K., Wetzels, M., & Jaspers, M. (2017) · JMIR Human Factors · doi:10.2196/humanfactors.7978 · Cited by 114 · see citing works
Using a sociotechnical framework to understand adaptations in health IT implementation
Novak, L. L., Holden, R. J., Anders, S. H., Hong, J. Y., & Karsh, B. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2013.01.009 · Cited by 97 · see citing works
Workarounds to hospital electronic prescribing systems: a qualitative study in English hospitals
Cresswell, K. M., Mozaffar, H., Lee, L., Williams, R., & Sheikh, A. (2016) · BMJ Quality & Safety · doi:10.1136/bmjqs-2015-005149 · Cited by 96 · see citing works
Waterson, P. E. (2013) · Applied Ergonomics · doi:10.1016/j.apergo.2013.07.004 · Cited by 96 · see citing works
Flanagan, M., Saleem, J. J., Millitello, L. G., Russ, A. L., & Doebbeling, B. N. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-000982 · Cited by 91 · see citing works
Self-citationHolden, R. J., Rivera-Rodriguez, A. J., Faye, H., Scanlon, M. C., & Karsh, B. (2012) · Cognition Technology & Work · doi:10.1007/s10111-012-0229-4 · Cited by 88 · see citing works
Ser, G., Robertson, A. R. R., & Sheikh, A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0077669 · Cited by 84 · see citing works
Lanham, H. J., Leykum, L. K., & McDaniel, R. R. (2011) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2011-000263 · Cited by 75 · see citing works
Cognitive ergonomics, socio-technical systems, and the impact of healthcare information technologies
Lawler, E., Hedge, A., & Pavlovic-Veselinovic, S. (2011) · International Journal of Industrial Ergonomics · doi:10.1016/j.ergon.2011.02.006 · Cited by 74 · see citing works
Saleem, J. J., Russ, A. L., Sanderson, P., Johnson, T. R., Zhang, J., & Sittig, D. F. (2009) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1638638 · Cited by 72 · see citing works
Self-citationAloyuni, S., Alharbi, R., Kashoo, F. Z., Alqahtani, M. M., Alanazi, A., Alzhrani, M., & Ahmad, M. (2020) · Healthcare · doi:10.3390/healthcare8040460 · Cited by 72 · see citing works
Redwood, S., Rajakumar, A., Hodson, J. A., & Coleman, J. J. (2011) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-11-29 · Cited by 70 · see citing works
The impact of electronic health records on collaborative work routines: A narrative network analysis
Chao, C. (2016) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2016.06.019 · Cited by 66 · see citing works
“I Did It My Way”: Social workers as secondary designers of a client information system
Huuskonen, S., & Vakkari, P. (2012) · Information Processing & Management · doi:10.1016/j.ipm.2012.05.003 · Cited by 63 · see citing works
Munyisia, E. N., Yu, P., & Hailey, D. M. (2011) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2011.08.009 · Cited by 62 · see citing works
You and me and the computer makes three: variations in exam room use of the electronic health record
Saleem, J. J., Flanagan, M., Russ, A. L., McMullen, C. K., Elli, L., Russell, S. A., Bennett, K. J., Matthias, M. S., Rehman, S. U., Schwartz, M. D., et al. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-002189 · Cited by 60 · see citing works
Self-citationCommunication Technology Integration into Social Work Practice
Bullock, A. N., & Colvin, A. D. (2015) · Advances in Social Work · doi:10.18060/18259 · Cited by 58 · see citing works
A typology of electronic health record workarounds in small-to-medium size primary care practices
Friedman, A., Crosson, J. C., Howard, J., Clark, E. C., Pellerano, M. B., Karsh, B., Crabtree, B. F., Jaén, C. R., & Cohen, D. J. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-001686 · Cited by 56 · see citing works
Holden, R. J. (2011) · Theoretical Issues in Ergonomics Science · doi:10.1080/1463922x.2010.549249 · Cited by 56 · see citing works
Collaborative Affordances of Medical Records
Bardram, J. E., & Houben, S. (2017) · Computer Supported Cooperative Work (CSCW) · doi:10.1007/s10606-017-9298-5 · Cited by 49 · see citing works
Wright, M. C., Borbolla, D. A., Waller, R. G., Fiol, G. D., Reese, T., Nesbitt, P., & Segall, N. (2019) · Journal of Biomedical Informatics · doi:10.1016/j.yjbinx.2019.100041 · Cited by 48 · see citing works
Saleem, J. J., Plew, W., Speir, R. C., Herout, J., Wilck, N. R., Ryan, D. M., Cullen, T., Scott, J. M., Beene, M. S., & Phillips, T. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2015.03.006 · Cited by 45 · see citing works
Self-citationOr, C. K., Tong, E. L. H., Tan, J., & Chan, S. (2018) · Journal of Medical Systems · doi:10.1007/s10916-018-0971-0 · Cited by 45 · see citing works
Militello, L. G., Arbuckle, N. B., Saleem, J. J., Patterson, E. S., Flanagan, M., Haggstrom, D. A., & Doebbeling, B. N. (2013) · Health Informatics Journal · doi:10.1177/1460458213476968 · Cited by 42 · see citing works
Self-citationRuss, A. L., Saleem, J. J., Justice, C. F., Woodward-Hagg, H., Woodbridge, P. A., & Doebbeling, B. N. (2010) · Health Informatics Journal · doi:10.1177/1460458210365981 · Cited by 41 · see citing works
Self-citationLyhne, S., Georgiou, A., Marks, A., Tariq, A., & Westbrook, J. I. (2012) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.01.013 · Cited by 40 · see citing works
Workarounds and Test Results Follow-up in Electronic Health Record-Based Primary Care
Menon, S., Murphy, D. R., Singh, H., Meyer, A. N. D., & Sittig, D. F. (2016) · Applied Clinical Informatics · doi:10.4338/aci-2015-10-ra-0135 · Cited by 40 · see citing works
Ma, S., Lawpoolsri, S., Soonthornworasiri, N., Khamsiriwatchara, A., Jandee, K., Taweeseneepitch, K., Pawarana, R., Jaiklaew, S., Kijsanayotin, B., & Kaewkungwal, J. (2016) · JMIR Public Health and Surveillance · doi:10.2196/publichealth.5347 · Cited by 32 · see citing works
Technological appropriations as workarounds
Barrett, A. K. (2018) · Information Technology and People · doi:10.1108/itp-01-2016-0023 · Cited by 38 · see citing works
Waterson, P., Glenn, Y., & Eason, K. (2012) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2011.10.011 · Cited by 31 · see citing works
Djalali, S., Ursprung, N., Rosemann, T. J., Senn, O., & Tandjung, R. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2015.08.001 · Cited by 32 · see citing works
Morrison, C. P., Fitzpatrick, G., & Blackwell, A. F. (2011) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2011.01.007 · Cited by 34 · see citing works
Lomotan, E. A., Hoeksema, L. J., Edmonds, D., Ramírez-Garnica, G., Shiffman, R. N., & Horwitz, L. I. (2011) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2011.11.004 · Cited by 35 · see citing works
Chen, Y., Lorenzi, N. M., Nyemba, S., Schildcrout, J. S., & Malin, B. (2014) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2014.04.006 · Cited by 30 · see citing works
Diño, M. J. S., & Ong, I. L. (2019) · The Journal of Medical Investigation · doi:10.2152/jmi.66.3 · Cited by 29 · see citing works
Information and Communication Technologies, Society and Human Beings
Haftor, D., & Mirijamdotter, A. (2010) · IGI Global eBooks · doi:10.4018/978-1-60960-057-0 · Cited by 41 · see citing works
Nov, O., & Schecter, W. P. (2012) · Journal of the American Society for Information Science and Technology · doi:10.1002/asi.22602 · Cited by 29 · see citing works
Eikey, E. V., Murphy, A. R., Reddy, M. C., & Xu, H. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2015.09.006 · Cited by 28 · see citing works
SEWA: A framework for sociotechnical analysis of electronic health record system workarounds
Blijleven, V., Koelemeijer, K., & Jaspers, M. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.02.012 · Cited by 27 · see citing works
Early experiences with the multidose drug dispensing system--a matter of trust?
Wekre, L. J., Melby, L. M. H., & Grimsmo, A. (2011) · Europe PMC (PubMed Central) · doi:10.3109/02813432.2011.554002 · Cited by 25 · see citing works
Human Factors in Critical Care Medical Environments
Drews, F. A. (2013) · Reviews of Human Factors and Ergonomics · doi:10.1177/1557234x13493250 · Cited by 23 · see citing works
Kessy, E., Kibusi, S. M., & Ntwenya, J. E. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1259268 · Cited by 21 · see citing works
Waterson, P. E., Hoonakker, P., & Carayon, P. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2013.01.001 · Cited by 21 · see citing works
Variation in Medication Therapy Management Delivery: Implications for Health Care Policy
Snyder, M. E., Jaynes, H. A., Gernant, S. A., Lantaff, W. M., Hudmon, K. S., & Doucette, W. R. (2018) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2018.24.9.896 · Cited by 20 · see citing works
Tolera, A., Oljira, L., Dingeta, T., Abera, A., & Roba, H. S. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.935945 · Cited by 20 · see citing works
Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work
Houben, S., Frost, M. M., & Bardram, J. E. (2015) · ACM Conference on Computer Supported Cooperative Work (CSCW) · doi:10.1145/2675133.2675164 · Cited by 19 · see citing works
Electronic health records : managing the transformation from a paper-based to an electronic system
Weeks, R. V. (2013) · UpSpace Institutional Repository (University of Pretoria) · Cited by 17 · see citing works
Integration of the Enterprise Electronic Health Record and Anesthesia Information Management Systems
Springman, S. R. (2011) · Anesthesiology Clinics · doi:10.1016/j.anclin.2011.05.007 · Cited by 16 · see citing works
Exploring Workarounds Related to Electronic Health Record System Usage: A Study Protocol
Blijleven, V., Koelemeijer, K., & Jaspers, M. (2017) · JMIR Research Protocols · doi:10.2196/resprot.6766 · Cited by 15 · see citing works
Wang, M., Yu, Y., Liu, L., Schoen, M. W., Kumar, A., Vargo, K., Colditz, G. A., Thomas, T. S., & Chang, S. (2023) · JCO Clinical Cancer Informatics · doi:10.1200/cci.23.00081 · Cited by 13 · see citing works
Trust Factors in Healthcare Technology: A Healthcare Professional Perspective
Abbas, R. M., Carroll, N., Richardson, I., & Beecham, S. (2018) · International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC) · doi:10.5220/0006594204540462 · Cited by 14 · see citing works
(2014) · PubMed · Cited by 13 · see citing works
"We Are Not Entirely Replacing Paper"
Jagannath, S., Sarcevic, A., & Forte, A. (2018) · ACM Conference on Computer Supported Cooperative Work (CSCW) · doi:10.1145/3272973.3274067 · Cited by 13 · see citing works
Saleem, J. J., Wilck, N. R., Murphy, J. J., & Herout, J. (2022) · Applied Clinical Informatics · doi:10.1055/s-0042-1748857 · Cited by 13 · see citing works
Self-citationPirnejad, H., Bal, R. A., & Shahsavar, N. (2010) · Studies in health technology and informatics · doi:10.3233/978-1-60750-588-4-719 · Cited by 13 · see citing works
Exploring Healthcare Professionals’ Perspectives on Electronic Medical Records: A Qualitative Study
Torkman, R., Ghapanchi, A. H., & Ghanbarzadeh, R. (2025) · Information · doi:10.3390/info16030236 · Cited by 12 · see citing works
Recording and use of information in a client information system in child protection work
Huuskonen, S. (2014) · Tampere University Institutional Repository (Tampere University) · Cited by 12 · see citing works
Kamath, J. R. A., & Donahoe-Anshus, A. L. (2011) · IGI Global eBooks · doi:10.4018/978-1-60960-872-9.ch015 · Cited by 11 · see citing works
Mount-Campbell, A. F., Evans, K. D., Woods, D. D., Chipps, E. M., Moffatt, S. D., & Patterson, E. S. (2019) · Journal of Cognitive Engineering and Decision Making · doi:10.1177/1555343418825429 · Cited by 11 · see citing works
Paper Persistence and Computer-based Workarounds with the Electronic Health Record in Primary Care
Saleem, J. J., Flanagan, M., Militello, L. G., Arbuckle, N. B., Russ, A. L., Burgo-Black, A. L., & Doebbeling, B. N. (2011) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/1071181311551136 · Cited by 11 · see citing works
Self-citationThe Workflow of Computerized Medication Ordering in Primary Care is Not Prescriptive
Russ, A. L., Saleem, J. J., McManus, M. S., Frankel, R. M., & Zillich, A. J. (2010) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/154193121005401207 · Cited by 10 · see citing works
Self-citationHouben, S., Frost, M. M., & Bardram, J. E. (2014) · ACM International Conference on Interactive Tabletops and Surfaces (ITS) · doi:10.1145/2669485.2669502 · Cited by 10 · see citing works
Electronic Health Records in the Emergency Room
Portela, F., Vilas-Boas, M., Santos, M. F., Abelha, A., Machado, J. M., Cabral, A., & Aragão, I. C. (2010) · IEEE/ACIS International Conference on Computer and Information Science (ICIS) · doi:10.1109/icis.2010.98 · Cited by 10 · see citing works
Cabitza, F., & Simone, C. (2012) · IGI Global eBooks · doi:10.4018/978-1-4666-0303-5.ch006 · Cited by 10 · see citing works
Monitoring Time Consumption in Complementary Diagnostic and Therapeutic Procedure Requests
Alpuim, A., Esteves, M., Pereira, S., & Santos, M. F. (2016) · Advances in bioinformatics and biomedical engineering book series · doi:10.4018/978-1-4666-9882-6.ch011 · Cited by 10 · see citing works
Performance, workload, and usability in a multiscreen, multi-device, information-rich environment
Saleem, J. J., & Weiler, D. T. (2018) · PeerJ Computer Science · doi:10.7717/peerj-cs.162 · Cited by 10 · see citing works
Self-citationHidden complexities in information flow between primary and specialty care clinics
Militello, L. G., Savoy, A., Porter, B. W., Porter, B. W., Flanagan, M., Wu, J. C., Adams, J. M., Rehman, S. U., Abbaszadegan, H., & Weiner, M. (2018) · Cognition Technology & Work · doi:10.1007/s10111-018-0486-y · Cited by 10 · see citing works
Salahuddin, L. B., Ismail, Z., Ghani, M. K. A., Aboobaider, B. M., & Basari, A. S. H. (2019) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13326 · Cited by 10 · see citing works
Developing a Shared Taxonomy of Workaround Behaviors for the Information Systems Field
Zainuddin, E., & Staples, D. S. (2016) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2016.652 · Cited by 9 · see citing works
Informatisation incrémentale ou de rupture ? Le cas du dossier patient hospitalier
Béjean, M., Kletz, F., Moisdon, J., & Sicotte, C. (2016) · Journal de gestion et d économie médicales · doi:10.3917/jgem.157.0445 · Cited by 9 · see citing works
Béjean, M., Kletz, F., & Moisdon, J. (2019) · Gestion et management public · doi:10.3917/gmp.064.0009 · Cited by 10 · see citing works
Wu, T. (2020) · Work and Occupations · doi:10.1177/0730888420922581 · Cited by 9 · see citing works
Modelling data activities in workarounds: a narrative network approach
Wibisono, A., Sammon, D., & Heavin, C. (2020) · Journal of Decision System · doi:10.1080/12460125.2020.1778874 · Cited by 9 · see citing works
Dabliz, R., Poon, S. K.-S., Fairbrother, G., Ritchie, A., Soo, G., Burke, R. A., Kol, M. R., Ho, R., Thai, L., Laurens, J., et al. (2020) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2020.104325 · Cited by 9 · see citing works
Going Paperless? Issues in Converting a Surgical Assessment Tool to an Electronic Version
Dudek, N. L., Papp, S., & Gofton, W. T. (2015) · Teaching and Learning in Medicine · doi:10.1080/10401334.2015.1044661 · Cited by 9 · see citing works
Almayahi, Z. K., Alswaidi, F., & Alzahrani, A. G. (2021) · Journal of the Egyptian Public Health Association · doi:10.1186/s42506-021-00074-1 · Cited by 8 · see citing works
Systematic Review of the Importance of Human Factors in Incorporating Healthcare Automation
Kurniawan, J., & Duffy, V. G. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-77820-0_8 · Cited by 8 · see citing works
Employee Well‐Being and Safety Behaviors
Halbesleben, J. R. B., & Bellairs, T. (2015) · Wiley eBooks · doi:10.1002/9781118979013.ch12 · Cited by 8 · see citing works
Efficiency Strategies for Facilitating Computerized Clinical Documentation in Ambulatory Care
Saleem, J. J., Stephanie, A., Frankel, R. M., Doebbeling, B. N., & Patterson, E. S. (2013) · Studies in health technology and informatics · doi:10.3233/978-1-61499-289-9-13 · Cited by 7 · see citing works
Self-citationHealth Information Technology Policy
Rudin, R. S., Tang, P. C., & Bates, D. W. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4474-8_27 · Cited by 7 · see citing works
Achieving and Resisting Change
Debono, D. S., Greenfield, D., Black, D. A., & Braithwaite, J. (2012) · Palgrave Macmillan eBooks · doi:10.1057/9780230355026_14 · Cited by 7 · see citing works
Boyd, A. D., Funk, E. A., Schwartz, S. M., Kaplan, B., & Keenan, G. M. (2010) · PubMed · Cited by 7 · see citing works
Factors in Physician Expectations of a Forthcoming Electronic Health Record Implementation
Harle, C. A., & Dewar, M. A. (2012) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2012.277 · Cited by 6 · see citing works
Nelson, S. D., LaFleur, J., Fiol, G. D., Evans, R. S., & Weir, C. R. (2015) · PubMed Central · Cited by 6 · see citing works
Henry, S. B., Dykes, P. C., Rossetti, S. C., & Ozbolt, J. G. (2021) · Springer eBooks · doi:10.1007/978-3-030-58721-5_17 · Cited by 6 · see citing works
A case study of user assessment of a corrections electronic health record.
Madison, L. G., & Phillip, W. R. (2011) · PubMed Central · Cited by 6 · see citing works
A Generic Method to Monitor Completeness and Speed of Medical Documentation Processes
Dugas‐Breit, S., & Dugas, M. (2011) · Methods of Information in Medicine · doi:10.3414/me09-01-0085 · Cited by 6 · see citing works
Cognitive Errors in Reconciling Complex Medication Lists.
Horsky, J., & Ramelson, H. Z. (2016) · PubMed Central · Cited by 6 · see citing works
Hu, Z., Hu, R., Yau, O., Teng, M. Y., Wang, P., Hu, G., & Singla, R. (2022) · JMIR Medical Informatics · doi:10.2196/34304 · Cited by 7 · see citing works
The peace of paper: Patient lists as work tools
Iversen, T. B., Landmark, A. D., & Tjora, A. (2014) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2014.09.008 · Cited by 6 · see citing works
Learning from workarounds in barcode medication administration: a Safety-II perspective
Cossul, D., Saurin, T. A., Fraga, R. D. S., Pasin, S. S., & Kuchenbecker, R. D. S. (2025) · Applied Ergonomics · doi:10.1016/j.apergo.2025.104605 · Cited by 7 · see citing works
Mensink, W., & Birrer, F. A. J. (2010) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 5 · see citing works
Kobayashi, L., Boss, R. M., Gibbs, F. J., Goldlust, E. J., Hennedy, M. M., Monti, J. E., & Siegel, N. A. (2011) · HERD Health Environments Research & Design Journal · doi:10.1177/193758671100400406 · Cited by 5 · see citing works
Srinivas, P., Faiola, A. J., & Khan, B. A. (2015) · IEEE International Conference on e-Health Networking, Applications and Services (Healthcom) · doi:10.1109/healthcom.2015.7454571 · Cited by 4 · see citing works
- Authors
- Saleem, J. J., Russ, A. L., Justice, C. F., Hagg, H., Ebright, P. R., Woodbridge, P. A., & Doebbeling, B. N.
- Affiliations
- Regenstrief Institute (US)
- Indiana University Indianapolis (US)
- VA Nebraska Western Iowa Health Care System (US)
- Corresponding author
- Saleem, Jason J.
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 78
- Issue
- 9
- Pages
- 618-628
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W1965739756
- Semantic Scholar
- 6f73746d8f0c94b5309f7465ff317ebb22d05f29
- Cited by
- 145
- References
- 28
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 6 · 2020: 6 · 2019: 7 · 2018: 10 · 2017: 6 · 2016: 12 · 2015: 11 · 2014: 12 · 2013: 15 · 2012: 9
- FWCI
- 29.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Medical Informatics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Services Research and Development
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Keywords
- electronic health records, human-technology integration, health information technology adoption, EHR design, clinical documentation, medical errors, veterans' health care, clinician behavior, task complexity, data security
- MeSH terms
- Documentation, Indiana, Medical History Taking, Paper, Practice Patterns, Physicians', Medical Records Systems, Computerized
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review