The DOI matches its Crossref record; 112 of the 116 references it cites were found in a registry or an index; none of the 54 sources its claims cite is checked for support yet.
Health information technology: fallacies and sober realities
Open accessAbstract
Current research suggests that the rate of adoption of health information technology (HIT) is low, and that HIT may not have the touted beneficial effects on quality of care or costs. The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. We discuss 12 HIT fallacies and their implications for design and implementation. These fallacies must be understood and addressed for HIT to yield better results. Foundational cognitive and human factors engineering research and development are essential to better inform HIT development, deployment, and use.
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Claims the paper makes
51 Not checked yet · 39 Own interpretation · 6 No basis given
In the paper
“Have programming errors and bugs;”
What the sources say
- Not checked yetcites 16 18 28 35 e 39
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“Be dependent on unreliable hardware or software platforms;”
What the sources say
- Not checked yetcites 16 18 28 35 e 39
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Current research demonstrates that health information technology (HIT) can improve patient safety and healthcare quality, in certain circumstances. 1 e 6”
What the sources say
- Not checked yetcites 1 e 6
boostedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“which is supported by strong theory and evidence from safety science, industrial and systems engineering, and social psychology. 62 64 65”
What the sources say
- Not checked yetcites 62 64 65
boosted- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we argue that the twin issues of the failure of HIT adoption and of HIT efficacy can be understood by examining a series of misguided beliefs about HIT.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Rests on an assumption: The fallacies described in the paper are widely held by HIT designers and policymakers.
In the paper
“Work well in one context or organization but be unsafe or even fail in another;”
What the sources say
- Not checked yetcites 16 18 28 35 e 39
plainconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HIT systems tend to have a ' magnifying ' property, wherein one exchanges a large number of small failures for a small number of large, potentially catastrophic failures.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“because HIT is designed, built, and implemented by humans, it will invariably have ' bugs ' and latent failure modes. 21 22”
What the sources say
- Not checked yetcites 21 22
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Currently, there are no regulatory requirements to evaluate HIT system safety even though these systems are known to directly affect patient care in both positive and negative ways. 2 17 18 27 e 34”
What the sources say
- Not checked yetcites 2 17 18 27 e 34
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Have been developed from erroneous or incomplete design specifications;”
What the sources say
- Not checked yetcites 16 18 28 35 e 39
plainconditional- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 28
- Probably not a substantial claim. 21
In the paper
“Equating HIT usage with design success can be misleading and may promulgate inappropriate policies to improve ' use ' . 67”
What the sources say
- Not checked yetcites [67] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“current efforts aimed at the nationwide deployment of health care ITwill not be sufficient to achieve the vision of 21st-century health care, and may even set back the cause if these efforts continue wholly without change from their present course.”
What the sources say
- Not checked yetcites [14] Stead WW Lin HS , eds. Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. Washington DC: National Academies Press, 2009.
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Currently, there are no regulatory requirements to evaluate HIT system safety even though these systems are known to directly affect patient care in both positive and negative ways. 2 17 18 27 e 34”
What the sources say
- Not checked yetcites 2 17 18 27 e 34
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“changing the order of medication options on a drop down pick list will influence clinicians ' ordering behavior.”
plaindirect- Asserted: passes — The authors put it forward as true.
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- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
In the paper
“A passive monitoring approach, as currently suggested by the Office of the National Coordinator, 49 seems likely to be both expensive and ultimately ineffective.”
What the sources say
- Not checked yetcites [49] Egerman P Probst M . Memorandum to David Blumenthal: Adoption-Certification Workgroup HIT Safety Recommendations. http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11673_911847_0_0_18/AdoptionCertificationLetterHITSafetyFINAL508.pdf (accessed 17 Aug 2010).
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
- Rests on an assumption: The current passive monitoring approach suggested by the Office of the National Coordinator is likely to be expensive and ineffective.
In the paper
“Change how clinicians do their daily work, thus introducing new potential failure modes. 16 18 28 35 e 39”
What the sources say
- Not checked yetcites 16 18 28 35 e 39
plainconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“or reduce costs. 13”
What the sources say
- Not checked yetcites [13] source
hedged- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“human factors engineers, social psychologists, and patient safety researchers long ago debunked the bad apple theory of human error, replacing it with the more accurate and useful systems view of error, 21 62 63”
What the sources say
- Not checked yetcites 21 62 63
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The complexity of HIT systems and the risk of potentiating serious error is sufficiently significant to demand effective regulatory oversight. 46”
What the sources say
- Not checked yetcites [46] Hoffman S Podgurski A . Finding a cure: the case for regulation and oversight of electronic health record systems. Harv J Law Technol 2008;22:104–65.
plainconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“This mismatch between who benefits and who pays leads to incomplete or inaccurate data entry ( ' garbage in d garbage out ' ), inefficiency, workarounds, and poor adoption. 74”
What the sources say
- Not checked yetcites [74] Abbott P Coenan A . Globalization and advances in information and communication technologies: The impact on nursing and health. Nurs Outlook 2008;58:238–46. source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many catastrophes in complex sociotechnical systems (eg, Three Mile Island) occur in such situations, particularly when the technology does not communicate effectively with its human users.”
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“computers are very good at repeatedly doing whatever they were told to do, just like a well-trained animal (ie, ' sitstay ' ). Computers implement human-derived rules and with a degree of consistency much higher than human workers.”
plain- Asserted: passes — The authors put it forward as true.
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- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Otherwise, unintended consequences, such as physicians and hospitals investing in HIT to the exclusion of what might actually be more effective local strategies (eg, use of nurse case managers or process redesign), may occur.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Healthcare is a complex sociotechnical system where simple metrics can mislead because they do not adequately consider the context of human decisions at the time they are made.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“computers are much more likely than humans to perform their clever and complex tricks at inappropriate times.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Computers cannot be described as being inherently ' smart ' .”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“As a result, problems have been framed too narrowly, leading to impoverished designs and disappointing ' solutions ' . 85”
What the sources say
- Not checked yetcites [85] source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“computer displays are not yet as portable, flexible, or well-designed as paper. 83”
What the sources say
- Not checked yetcites [83] Sellen AJ Harper RHR . The Myth of the Paperless Office. Cambridge, MA: MIT Press, 2002. source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“People, on the other hand, are smart, creative, and context sensitive. 79”
What the sources say
- Not checked yetcites [79] Norman DA . Things That Make Us Smart: Defending Human Attributes In The Age Of The Machine. New York: Basic Books, 1994.
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the promulgation of ' meaningful use ' may lead to undesirable consequences if such use is not contextually grounded and tied to improved efficiency, learning, ease of use, task and information flow, cognitive load, situation awareness, clinician and patient satisfaction, reduced errors, and faster error recovery.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“The 'fi eld of dreams ' fallacy is well-known in other domains where it is also referred to as the ' designer fallacy ' or ' designercentered design ' . 77”
What the sources say
- Not checked yetcites [77] Hoffman RR Militello LG . Perspectives on Cognitive Task Analysis. New York: Taylor and Francis, 2009. source
boosted- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“User-created paper artifacts typically support patientspecific cognition, situational awareness, task and information communication, and coordination, all essential to safe quality patient care.”
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“most clinicians are not experts in device design, user interface design, or the relationship between HIT design and performance.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The paper forms are not simple data repositories that, once computerized, could be eliminated. Rather such ' scraps ' of paper are sophisticated cognitive artifacts that support memory, forecasting and planning, communication, coordination, and education.”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Paper will persist, and should persist, if HIT is not able to provide similar support.”
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By seeing only what they know, such teams do not understand how clinical work is really carried out, what clinicians ' real needs are, and where the potential hazards and leverage points lie.”
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“some clinical decision support (CDS) rules force clinicians to stop and respond to the CDS, interrupting their work, substituting the designer ' s judgment for that of the clinician. 71”
What the sources say
- Not checked yetcites [71] Bisantz AM Wears RL . Forcing functions: the need for restraint. Ann Emerg Med 2008;53:477–9. source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it is misguided to believe that healthcare is unique or that no one outside of the domain could possibly understand it.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it takes special training and skills to evaluate a human e computer interface, assess the usability of a system, or predict the changes in communication patterns and social structures that a design might induce.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a lack of use is not evidence of a flawed system d clinicians may ignore features like reminders for legitimate reasons.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Technology can be at its worst, and humans at their best, when novel and complex situations arise.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Validation of HITcannot be achieved by asking a clinician if they like the design. Validation requires thorough experimental testing of the design based on well-defined performance criteria.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, use may not truly be meaningful in a clinical sense until HIT truly supports users ' needs.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While it may not take 60 years for HIT to become as safe, if we do not change from our current course, it never will be.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
- Rests on an assumption: Commercial aviation has become very safe in the more than 60 years since Fitts' publication.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These challenges will only be overcome by collaborating substantively with those who can contribute unique and important expertise such as human factors engineers, applied psychologists, medical sociologists, communication scientists, cognitive scientists, and interaction designers.”
- Also stated in: § WHAT SHOULD WE DO NOW? · p. 5 · plain
“HIT stands to benefit in the same way.”
plainconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Pilots and nuclear power operators did not improve safety on their own; they worked closely with experts in cognitive, social, and physical performance and safety.
- Also stated in: § WHAT SHOULD WE DO NOW? · p. 5 · plain
In the paper
“Exemplary research on relevant topics has been carried out for several decades, 89 e 98 but it does not seem that commercial HIT has benefited adequately from these findings.”
What the sources say
- Not checked yetcites 89 e 98
hedged- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HITaffords real opportunities for improving quality and safety. However, at the same time, it creates substantial challenges, especially during everyday clinical work.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These steps alone will require a significant investment by vendors, healthcare organizations, and government funders.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Current meaningful use rules and deadlines leave little time for HIT product improvement and testing, incentivizing rapid implementation of whatever is available”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper relies on this without support.
The fallacies described in the paper are widely held by HIT designers and policymakers.
“Many designers and policymakers believe that the risks of HIT are minor and easily manageable.”
The paper relies on this without support.
No other hazardous industry deploys safety critical IT without some form of independent hazard analysis.
“No other hazardous industry deploys safety critical IT without some form of independent hazard analysis (eg, a ' safety case ' ); it is unwise for healthcare to continue to do so.”
The paper relies on this without support.
The current passive monitoring approach suggested by the Office of the National Coordinator is likely to be expensive and ineffective.
“A passive monitoring approach, as currently suggested by the Office of the National Coordinator, 49 seems likely to be both expensive and ultimately ineffective.”
The paper relies on this without support.
There are fundamental gaps in awareness, recognition, and application of existing scientific knowledge, especially in human factors, systems engineering, and cognitive engineering, that could help solve some of HIT's biggest problems.
“There are fundamental gaps in the awareness, recognition, and application of existing scientific knowledge bases, especially related to human factors, and systems and cognitive engineering, that could help address some of HIT ' s biggest problems.”
The paper relies on this without support.
Pilots and nuclear power operators did not improve safety on their own; they worked closely with experts in cognitive, social, and physical performance and safety.
“Pilots did not improve aviation safety nor did nuclear power operators improve nuclear safety . by themselves. Rather they worked closely with experts in cognitive, social, and physical performance and safety to improve safety.”
The paper relies on this without support.
People have very limited insight into their own performance and even less ability to explain what might improve it.
“Humans have very limited insight into their own performance, and even more limited ability to articulate what might improve it.”
The paper relies on this without support.
Commercial aviation has become very safe in the more than 60 years since Fitts' publication.
“In the more than 60 years since that publication, commercial aviation has become very safe.”
The paper relies on this without support.
Throughout human history, major innovations have always brought new perils.
“Throughout human history, significant innovations have always been associated with new perils.”
The paper relies on this without support.
HIT works best and is safest when customized to local circumstances and workflows.
“Despite compelling evidence that HITworks best (and is safest) when it is customized to local circumstances and workflows”
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“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 [11]
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“This mismatch aligns with the law of Grudin [47], which posits that those required to use new technologies bear the burden of their inefficiencies.”
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“text-based information within alerts should be utilized for efficient cognitive processing by the user.(9) While human factors have been well studied in the general safety literature, few studies have addressed human factors and the design of clinical information systems empirically.”
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“Furthermore, clinicians have experienced them as disruptive and inefficient [9, 10].”
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“However, implementing new IT systems into healthcare is often problematic [1] [2] and the diffusion of IT innovations into the frontlines of healthcare practice is often met by resistance [3] [4] [5].”
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“Satisfaction measures are strongly related to other important dimensions of quality, such as perceived usefulness and acceptance (Holden and Karsh, 2010; Karsh et al., 2010; Or and Karsh, 2009; Or et al., 2011) therefore, the ability to monitor end-user satisfaction of products and services…”
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“Issues arising from using such HIT safely are increasingly being recognized as more healthcare organizations across the health system implement these technologies.(34)”
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Exploring nurses’ confirmed expectations regarding health IT: A phenomenological study
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“As telemedical solutions such as VC are not widely used in health care [43,44], this user group represents a majority of patients.”
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“The design must incorporate the multiple users and the multiple workflow possibilities and deviations for nonroutine conditions (Karsh et al., 2010).”
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Clinical Decision Support and Malpractice Risk
Greenberg, M. D., & Ridgely, M. S. (2011) · JAMA · doi:10.1001/jama.2011.929 · Cited by 34
“These sorts of results could prevent the technologies from achieving their potential benefits in making patients safer and in reducing the risks of medication error.(5) The Office of the National Coordinator for Health Information Technology (ONC) is addressing this problem through its Advancing Clinical Decision Supp…”
BackgroundPowell, L., Sittig, D. F., Chrouser, K. L., & Singh, H. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.6752 · Cited by 34
Information Quality in Healthcare
Cabitza, F., & Batini, C. (2016) · Data-centric systems and applications · doi:10.1007/978-3-319-24106-7_13 · Cited by 33
Al‐Dorzi, H. M., Tamim, H., Cherfan, A. J., Hassan, M. A., Taher, S. M., & Arabi, Y. M. (2011) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-11-71 · Cited by 28
“…of health information technology which undermine its efficacy and suggested that collaboration between human factors engineers, applied psychologists, medical sociolo-gists, communication scientists, cognitive scientists and interaction designers were needed to overcome these challenges [32].”
BackgroundUsability of a novel clinician interface for genetic results
Neri, P. M., Pollard, S. E., Volk, L. A., Newmark, L. P., Varugheese, M., Baxter, S. M., Aronson, S., Rehm, H. L., & Bates, D. W. (2012) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2012.03.007 · Cited by 32
Klappe, E. S., de Keizer, N. F., & Ronald Cornet, A. (2020) · Applied Clinical Informatics · doi:10.1055/s-0040-1712466 · Cited by 31
Review of Social and Organizational Issues in Health Information Technology
Kuziemsky, C. E. (2015) · Healthcare Informatics Research · doi:10.4258/hir.2015.21.3.152 · Cited by 33
“A systematic review of HIT implementation identified better reporting of context as the biggest need in HIT evaluation [35].”
BackgroundSmith, M., Murphy, D., Laxmisan, A., Sittig, D., Reis, B., Esquivel, A., & Singh, H. (2013) · Applied Clinical Informatics · doi:10.4338/aci-2013-04-ra-0019 · Cited by 31
“In this way AWARE avoids the problem of burdening providers with data entry tasks for administrative purposes [58].”
BackgroundBorycki, E. M., Carayon, P., Jaspers, M., Sylvia Pelayo, A., & Beuscart-Zéphir, M.-C. (2013) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1638835 · Cited by 32
“More importantly, researchers have identified that some software features, functions and workflows either improve or detract HIT’s safety and quality [11, 12, 23-26].”
BackgroundBrumen, B., Heričko, M., Sevčnikar, A., Završnik, J., & Hölbl, M. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2471 · Cited by 31
“Because of time constraints, many health care goals, and the tasks or decisions needed to pursue those goals, these are intentionally deferred until a future opportunity [82], if it ever comes.”
The decision aid is the easy part: workflow challenges of shared decision making in cancer care
Salwei, M. E., Ancker, J. S., & Weinger, M. B. (2023) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djad133 · Cited by 31
Self-citationElectronic health records: research into design and implementation
Beasley, J. W., Holden, R. J., & Sullivan, F. (2011) · British Journal of General Practice · doi:10.3399/bjgp11x601244 · Cited by 31
Understanding health care communication preferences of veteran primary care users
LaVela, S. L., Schectman, G., Gering, J., Locatelli, S. M., Gawron, A., & Weaver, F. M. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.06.004 · Cited by 29
“However, despite advances in the availability of communication technologies, adoption of these methods remains low in general, among both patients and providers [8].”
BackgroundIs Healthcare Information Technology Based on Evidence?
Koppel, R. (2013) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1638826 · Cited by 23
Understanding Unintended Consequences and Health Information Technology
Randell, R., Borycki, E. M., & Kuziemsky, C. E. (2016) · Yearbook of Medical Informatics · doi:10.15265/iy-2016-027 · Cited by 29
“While there is a body of research on organizational and social issues and HIT [11-14], these issues remain underrepresented in evaluation strategies involving UICs [12, 14].”
Human Factors of Health Information Technology—Challenges and Opportunities
Asan, O., & Carayon, P. (2017) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2017.1282755 · Cited by 28
Adeleke, I. T. (2015) · American Journal of Health Research · doi:10.11648/j.ajhr.s.2015030101.13 · Cited by 29
“Furthermore, researchers have reported that sites where CPOE were implemented still experience high rates of medication errors and adverse drug events (ADEs) [20], errors related to entry, retrieval, communication and coordination of health information [21] and low adoption rate of HIT [22].”
BackgroundMethods for Addressing Technology-induced Errors: The Current State
Dexheimer, J. W., Cossio, C. H. L., Gong, Y., Jensen, S., Kaipio, J., Kennebeck, S., Kirkendall, E. S., Kushniruk, A. W., Kuziemsky, C. E., Marcilly, R., et al. (2016) · Yearbook of Medical Informatics · doi:10.15265/iy-2016-029 · Cited by 26
“Poorly implemented HIT has the potential to lead to large scale errors, particularly in complex situations and contexts [59].”
A literature review of human factors and ergonomics within the pharmacy dispensing process
Weir, N., Newham, R., & Bennie, M. (2019) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2019.08.029 · Cited by 28
Resilient practices in maintaining safety of health information technologies
Smith, M. W., Ash, J. S., Sittig, D. F., & Singh, H. (2014) · Journal of Cognitive Engineering and Decision Making · doi:10.1177/1555343414534242 · Cited by 26
“…management of EHR-related safety is critical given the inherent safety risks associated with EHRs (Ash, Sittig, Campbell, Guappone, & Dykstra, 2007; Karsh, Weinger, Abbott, & Wears, 2010; Sittig & Singh, 2009; Skorve, 2010; Walker et al., 2008) and the rapid adoption of HIT in the United States…”
BackgroundA qualitative study of physician perspectives on adaptation to electronic health records
Sieck, C. J., Pearl, N., Bright, T. J., & Yen, P.-Y. (2020) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-1030-6 · Cited by 26
Melnick, E. R., Lopez, K., Hess, E. P., Abujarad, F., Brandt, C., Shiffman, R. N., & Post, L. A. (2015) · eGEMs (Generating Evidence & Methods to improve patient outcomes) · doi:10.13063/2327-9214.1136 · Cited by 24
“Understanding that users may “have very limited insight into their own performance, and even more limited ability to articulate what might improve it,” we triangulated the focus group findings with direct field observation in the form of a cognitive task analysis.(13) The analysis”
MethodRe-examining health IT policy: what will it take to derive value from our investment?
Riskin, L., Koppel, R., & Riskin, D. J. (2014) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2014-003065 · Cited by 24
“As of 2014, the benefit of HIT remains controversial.(9,14)”
Background
Metadata
- Authors
- Karsh, B.-T., Weinger, M. B., Abbott, P. A., & Wears, R. L.
- Affiliations
- University of Wisconsin–Madison (US)
- Vanderbilt University (US)
- Johns Hopkins University (US)
- University of Florida (US)
- Corresponding author
- Karsh, Ben-Tzion
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-11
- Volume
- 17
- Issue
- 6
- Pages
- 617-623
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3000760
- OpenAlex
- W2115602750
- Cited by
- 365
- References
- 116
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 10 · 2021: 18 · 2020: 29 · 2019: 42 · 2018: 25 · 2017: 21 · 2016: 24 · 2015: 36 · 2014: 28 · 2013: 48 · 2012: 34
- FWCI
- 62.14
- 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)
- Funders
- Centers for Disease Control and Prevention (R18SH017899)
- Agency for Healthcare Research and Quality (R18HS017902, HS016651, U18HS016651)
- U.S. National Library of Medicine (R01LM008923)
- 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
- health information technology, quality of care, health care costs, human factors engineering, cognitive engineering
- MeSH terms
- Attitude to Health, Diffusion of Innovation, Health Policy, Humans, Medical Informatics, Technology Assessment, Biomedical, United States
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