Reducing the Frequency of Errors in Medicine Using Information Technology
Open accessAbstract
BACKGROUND: Increasing data suggest that error in medicine is frequent and results in substantial harm. The recent Institute of Medicine report (LT Kohn, JM Corrigan, MS Donaldson, eds: To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press, 1999) described the magnitude of the problem, and the public interest in this issue, which was already large, has grown. GOAL: The goal of this white paper is to describe how the frequency and consequences of errors in medical care can be reduced (although in some instances they are potentiated) by the use of information technology in the provision of care, and to make general and specific recommendations regarding error reduction through the use of information technology. RESULTS: General recommendations are to implement clinical decision support judiciously; to consider consequent actions when designing systems; to test existing systems to ensure they actually catch errors that injure patients; to promote adoption of standards for data and systems; to develop systems that communicate with each other; to use systems in new ways; to measure and prevent adverse consequences; to make existing quality structures meaningful; and to improve regulation and remove disincentives for vendors to provide clinical decision support. Specific recommendations are to implement provider order entry systems, especially computerized prescribing; to implement bar-coding for medications, blood, devices, and patients; and to utilize modern electronic systems to communicate key pieces of asynchronous data such as markedly abnormal laboratory values. CONCLUSIONS: Appropriate increases in the use of information technology in health care- especially the introduction of clinical decision support and better linkages in and among systems, resulting in process simplification-could result in substantial improvement in patient safety.
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Emerging evidence suggests that health information technology may cause new patient safety concerns and other unintended consequences due to usability issues, disruptions of clinical processes, and unsafe workarounds.
“However, emerging evidence suggests that HIT may cause new patient safety concerns and other unintended consequences due to usability issues, disruptions of clinical processes, and unsafe workarounds to circumvent technology-related constraints.2–16”
From An analysis of electronic health record-related patient safety concerns (2014) · cites this paper as [5]
Technology can introduce new uncertainties and patient safety risks by disrupting established work patterns, creating new risks in practice, and encouraging workarounds.
“research suggests that technology may lead to new uncertainties and risks for patient safety through disrupting established work patterns, creating new risks in practice, and encouraging workarounds.”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [5]
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- Authors
- Bates, D. W., Cohen, M., Leape, L. L., Overhage, J. M., Shabot, M. M., & Sheridan, T.
- Affiliations
- Harvard University (US)
- Corresponding author
- Bates, D. W.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-07-01
- Volume
- 8
- Issue
- 4
- Pages
- 299-308
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC130074
- OpenAlex
- W2147886517
- Cited by
- 959
- References
- 43
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 17 · 2023: 18 · 2022: 17 · 2021: 17 · 2020: 17 · 2019: 33 · 2018: 38 · 2017: 35 · 2016: 39 · 2015: 51 · 2014: 66 · 2013: 44 · 2012: 44
- FWCI
- 116.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- medical errors, patient safety, clinical decision support, computerized prescribing, electronic health records, health information exchange, adverse event prevention, health information technology, To Err Is Human
- MeSH terms
- Humans, Drug Prescriptions, Quality of Health Care, Medical Records Systems, Computerized, Systems Integration, Medical Errors, Decision Support Systems, Clinical
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