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Electronic Health Records and National Patient-Safety Goals
Open accessAbstract
Hospitals and clinics are adapting to new technologies and implementing electronic health records, but the efforts need to be aligned explicitly with goals for patient safety. EHRs bring the risks of both technical failures and inappropriate use, but they can also help to monitor and improve patient safety.
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“Digital systems frequently mediate clinical work in ways that reduce direct visibility of system state and process integrity.”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [28]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Organisational guidance such as the SAFER Guides reflects this shift by emphasising governance, monitoring, and continuous self-assessment as essential components of EHR safety, rather than treating safety as a function of software reliability alone (28, 48).”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [28]
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“Rather than focusing primarily on preventing individual errors, the findings suggest that safer digital healthcare depends on strengthening organisational capacity to detect emerging hazards, contain their effects, and learn from system-level vulnerabilities (28, 55).”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [28]
In the citing paper
“The second phase addresses unsafe or inappropriate use of technology as well as unsafe changes in the overall workflow that emerge due to technology use.”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [27]
In the citing paper
“The first phase is concerned with safety events that are unique and specific to technology (ie, unsafe technology), which often emerge early in the process of implementation.”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [27]
In the citing paper
“While the boundaries between the phases may not always be distinct”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [27]
In the citing paper
“The third phase addresses use of technology proactively to identify and monitor potential safety concerns before harm occurs to the patient.”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [27]
In the citing paper
“Therefore, to understand the intersection of EHR and patient safety , Sittig and Singh 27 further proposed a three-phase model to account for the variation in the stages of implementation, levels of complexity, and related patient safety concerns within an EHR-enabled healthcare system.”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [27]
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A red‐flag‐based approach to risk management of EHR‐related safety concerns
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Self-citationDiabetes management challenges in Iran: A qualitative content analysis
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Sittig, D. F., Salimi, M., Aiyagari, R. M., Banas, C. A., Clay, B. J., Gibson, K., Goel, A., Hines, R. B., Longhurst, C., Mishra, V. K., et al. (2018) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocy033 · Cited by 16
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Evaluation of the patient with an exposure-related disease
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Toward More Proactive Approaches to Safety in the Electronic Health Record Era
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Data saves lives: optimising routinely collected clinical data for rare disease research
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Metadata
- Authors
- Sittig, D. F., & Singh, H.
- Affiliations
- Memorial Hermann (US)
- Michael E. DeBakey VA Medical Center (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-11-08
- Volume
- 367
- Issue
- 19
- Pages
- 1854-1860
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3690003
- OpenAlex
- W2116241811
- Cited by
- 204
- References
- 48
- Citations by year
- 2026: 11 · 2025: 4 · 2024: 13 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 16 · 2018: 20 · 2017: 13 · 2016: 25 · 2015: 23 · 2014: 28 · 2013: 22 · 2012: 1
- FWCI
- 38.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (R18HS017820)
- National Cancer Institute (K23CA125585)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, patient safety, National Patient Safety Goals, EHR implementation, technical failure, patient safety monitoring, hospitals
- MeSH terms
- Goals, Humans, Software, United States, Medical Records Systems, Computerized, Computer Security, American Recovery and Reinvestment Act, Electronic Health Records, Patient Safety, Meaningful Use
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