A new sociotechnical model for studying health information technology in complex adaptive healthcare systems
Open accessAbstract
BACKGROUND: Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). METHOD: This manuscript introduces an eight-dimensional model specifically designed to address the sociotechnical challenges involved in design, development, implementation, use and evaluation of HIT within complex adaptive healthcare systems. DISCUSSION: The eight dimensions are not independent, sequential or hierarchical, but rather are interdependent and inter-related concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the 'language' of clinical applications. The human--computer interface includes all aspects of the computer that users can see, touch or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end user, including potential patient-users. Workflow and communication are the processes or steps involved in ensuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organisational features (eg, policies, procedures and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Digitisation redistributes responsibility across human and technical actors.
“Digitisation redistributes responsibility across human and technical actors.”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [13]
In “Moving towards a New Socio-technical Model for HIT” (page unavailable), the paper says care is shifting toward patients’ homes, software can enforce organizational policies, and some apparent user problems arise from system design. These passages support a change in how work and problems are distributed with HIT, but the paper does not explicitly assign responsibility to technical actors. (LLM, conf=0.78)
Experimental — accuracy not yet measuredDigital systems reduce visibility of system state and process integrity, making HIT hazards latent and detected indirectly through downstream consequences.
“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 [13]
In “Moving towards a New Socio-technical Model for HIT” (page unavailable), the paper says users are generally unaware of much of the computing infrastructure until it fails, supporting reduced visibility of one aspect of system state. It does not establish the broader claim that digital mediation reduces direct visibility of clinical process integrity, or that HIT hazards are detected only indirectly through downstream consequences. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDiffusion of responsibility complicates accountability and can create gaps in oversight, particularly when responsibilities for monitoring, escalation, and remediation are not clearly defined.
“This diffusion complicates accountability and can create gaps in oversight, particularly when responsibilities for monitoring, escalation, and remediation are not clearly defined (13).”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [13]
The HIT Use section reports missed follow-up of abnormal test results and identifies organizational policies about who was responsible as relevant. The Background section calls for defined decision-making, monitoring, and governance processes. The paper does not specifically say that diffusion of responsibility creates oversight gaps, or discuss unclear escalation and remediation responsibilities. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDecisions about information accuracy, timing, and relevance are increasingly mediated by algorithms, system configurations, and interoperability rules that are often opaque to end users.
“Decisions about information accuracy, timing, and relevance are increasingly mediated by algorithms, system configurations, and interoperability rules that are often opaque to end users (1, 13).”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [13]
In “HIT Evaluation” (page unavailable), the paper reports that a software configuration error prevented some test-result notifications from reaching clinicians; “Moving towards a New Socio-technical Model for HIT” says users are generally unaware of underlying infrastructure until it fails. These passages support the role of system configuration and some lack of visibility, but do not establish the broader claim about increasingly algorithm-mediated judgments of accuracy and relevance or opaque interoperability rules. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe interest in trialing ambient AI scribes in the ICU was tempered by concerns about the sociotechnical implications of voice-based AI in team-based, high-risk environments.
“The interest in trialing ambient AI scribes in the ICU was tempered by concerns about the sociotechnical implications of voice-based AI in team-based, high-risk environments, highlighting the need for careful, context-sensitive implementation [27].”
From Clinician Perspectives on Ambient AI Scribes in the Intensive Care Unit: Qualitative Interview Study (2026) · cites this paper as [27]
The Introduction describes a sociotechnical framework for studying safe implementation of health IT in complex clinical settings, and “Relationships and Interactions between our Model’s Components” explains why a system that works in one unit may fail in another. This supports the need for context-sensitive implementation, but the paper does not report interest in trialing ambient AI scribes in the ICU or concerns specifically about voice-based AI. (LLM, conf=0.86)
Experimental — accuracy not yet measured
The interview guide was previously developed based on sociotechnical theory and will explore key constructs including perceptions of usefulness, resource needs and constraints, barriers and facilitators to implementation, culture of safety, and adaptations.
“The interview guide was previously developed based on sociotechnical theory and will explore the following key constructs (Table 3): perceptions of usefulness, resource needs and constraints, barriers and facilitators to implementation, culture of safety, and adaptations [13,23].”
From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [13]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredA coding framework rooted in the 8 dimensions of sociotechnical theory has been developed.
“A coding framework rooted in the 8 dimensions of sociotechnical theory has been developed along the following codes: hardware and software, clinical content, human-computer interface, people, workflow and communication, internal organizational features, and external rules and regulations [13].”
From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [13]
The Abstract and “Moving towards a New Socio-technical Model for HIT” describe an eight-dimensional model and identify the seven dimensions listed in the citing sentence. The source describes a model, not a coding framework, and the cited list omits its eighth dimension, measurement and monitoring. Our copy provides no page numbers for these passages. (LLM, conf=0.87)
Experimental — accuracy not yet measuredExisting sociotechnical models and safety frameworks have provided important insights into the role of system interactions and organisational context.
“Existing approaches, including sociotechnical models and safety frameworks, have provided important insights into the role of system interactions and organisational context (13, 16, 17, 28, 48).”
From Why digital health fails silently: a sociotechnical theory of health information technology–related risk (2026) · cites this paper as [13]
This study is informed by sociotechnical theory, which offers a paradigm for studying health information technology innovations.
“This study is informed by sociotechnical theory, which offers a paradigm for studying health information technology innovations [13].”
From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [13]
This convergent mixed method approach will allow quantification of feasibility and acceptability while qualitatively assessing user experiences using CFIR and sociotechnical theory.
“This convergent mixed method approach will allow us to quantify the feasibility and acceptability of the ICU-PAUSE tool while also qualitatively assessing user experiences with the tool using the established implementation frameworks of CFIR and sociotechnical theory [13,14,17].”
From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [13]
User interaction, the EHR interface, institutional workflows, and regulatory policies are dynamic and interdependent.
“We recognize that user interaction, the EHR interface, institutional workflows, and regulatory policies are all dynamic and interdependent.”
From Improving Communication in Intensive Care Unit to Ward Transitions: Protocol for Multisite National Implementation of the ICU-PAUSE Handoff Tool (2023) · cites this paper as [13]
Detecting and preventing EHR-related safety concerns is challenging because concerns are often multifaceted, involving unsafe technological features, user behaviors, organizational characteristics, and rules and regulations.
“Detecting and preventing EHR-related safety concerns is challenging because concerns are often multifaceted, involving not only potentially unsafe technological features of the EHR but also EHR user behaviors, organizational characteristics, and rules and regulations that guide EHR-related activities.”
From An analysis of electronic health record-related patient safety concerns (2014) · cites this paper as [24]
The authors previously developed a sociotechnical model that proposes eight interdependent dimensions essential to understand EHR-related safety.
“For instance, we previously developed a sociotechnical model that proposes eight interdependent dimensions that are essential to understand EHR-related safety (table 1; Sittig and Singh model).24 34”
From An analysis of electronic health record-related patient safety concerns (2014) · cites this paper as [24]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
User Acceptance of Information Technology: Toward A Unified View1
Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003) · MIS Quarterly · doi:10.2307/30036540 · Cited by 45,035 · see citing works
Rogers, E. M., Singhal, A., & Quinlan, M. M. (2019) · Routledge eBooks · doi:10.4324/9780203710753-35 · Cited by 37,557 · see citing works
Hutchins, E. (1995) · doi:10.7551/mitpress/1881.001.0001 · Cited by 10,801 · see citing works
Human error: models and management
Reason, J. (2000) · BMJ · doi:10.1136/bmj.320.7237.768 · Cited by 5,665 · see citing works
Designing the user interface: Strategies for effective human-computer interaction
(1993) · Applied Ergonomics · doi:10.1016/0003-6870(93)90471-k · Cited by 5,592 · see citing works
The Psychology of Everyday Things
Massaro, D. W., & Norman, D. A. (1990) · The American Journal of Psychology · doi:10.2307/1423268 · Cited by 3,475 · see citing works
Risk management in a dynamic society: a modelling problem
Rasmussen, J. (1997) · Safety Science · doi:10.1016/s0925-7535(97)00052-0 · Cited by 2,994 · see citing works
The Technology Acceptance Model: Its past and its future in health care
Holden, R. J., & Karsh, B.-T. (2010) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2009.07.002 · Cited by 2,669 · see citing works
Diffusion of Innovations, 5th Edition
Rogers, E. M., Simon, 。., & Schuster (2003) · Cited by 2,049 · see citing works
Work system design for patient safety: the SEIPS model
Carayon, P., Schoofs Hundt, A., Karsh, B.-T., Gurses, A. P., Alvarado, C. J., Smith, M., & Flatley Brennan, P. (2006) · Quality in Health Care · doi:10.1136/qshc.2005.015842 · Cited by 1,795 · cited 1× · see citing works
“Third, Carayon's Systems Engineering Initiative for Patient Safety model”
Ash, J. S. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1471 · Cited by 1,789 · see citing works
An investigation of the Therac-25 accidents
Leveson, N. G., & Turner, C. S. (1993) · Computer · doi:10.1109/mc.1993.274940 · Cited by 1,245 · see citing works
Han, Y. Y., Carcillo, J. A., Venkataraman, S. T., Clark, R. S. B., Watson, R. S., Nguyen, T. C., Bayir, H., & Orr, R. A. (2005) · Pediatrics · doi:10.1542/peds.2005-1287 · Cited by 1,149 · see citing works
Overriding of Drug Safety Alerts in Computerized Physician Order Entry
van der Sijs, H., Aarts, J., Vulto, A., & Berg, M. (2006) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1809 · Cited by 1,117 · see citing works
Framework for analysing risk and safety in clinical medicine
Vincent, C. A., Taylor‐Adams, S. E., & Stanhope, N. (1998) · BMJ · doi:10.1136/bmj.316.7138.1154 · Cited by 910 · see citing works
Kijsanayotin, B., Pannarunothai, S., & Speedie, S. M. (2009) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2008.12.005 · Cited by 755 · see citing works
Harrison, M. I., Koppel, R., & Bar-Lev, S. (2007) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2384 · Cited by 691 · see citing works
Health Care Organizations as Complex Adaptive Systems
Begun, J. W., Zimmerman, B. J., & Dooley, K. J. (2003) · Cited by 284 · see citing works
Greenhalgh, T., Stramer, K., Bratan, T., Byrne, E., Russell, J., & Potts, H. W. W. (2010) · BMJ · doi:10.1136/bmj.c3111 · Cited by 275 · see citing works
Clinical Terminology: Why Is it so Hard?
Rector, A. L. (1999) · Methods of Information in Medicine · doi:10.1055/s-0038-1634418 · Cited by 238 · see citing works
Rosenbloom, S. T., Miller, R. A., Johnson, K. B., Elkin, P. L., & Brown, S. H. (2006) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1957 · Cited by 229 · see citing works
Singh, H., Thomas, E. J., Mani, S., Sittig, D., Arora, H., Espadas, D., Khan, M. M., & Petersen, L. A. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.263 · Cited by 212 · cited 1× · see citing works
“Safe and effective use of an EHR-based notification system involves many factors that are addressed by almost all dimensions of our model.”
BackgroundSelf-citationHazlehurst, B. L., McMullen, C. K., & Gorman, P. (2007) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2007.02.001 · Cited by 197 · see citing works
Turning Off Frequently Overridden Drug Alerts: Limited Opportunities for Doing It Safely
van der Sijs, H., Aarts, J., van Gelder, T., Berg, M., & Vulto, A. (2008) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2311 · Cited by 175 · see citing works
Ash, J. (1997) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.1997.0040102 · Cited by 174 · see citing works
Singh, H., Thomas, E. J., Sittig, D. F., Wilson, L., Espadas, D., Khan, M. M., & Petersen, L. A. (2010) · The American Journal of Medicine · doi:10.1016/j.amjmed.2009.07.027 · Cited by 160 · see citing works
Self-citationWorkflow modeling in critical care: Piecing together your own puzzle
Malhotra, S., Jordan, D. A., Shortliffe, E. H., & Patel, V. L. (2006) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2006.06.002 · Cited by 157 · see citing works
The Impact of Prescribing Safety Alerts for Elderly Persons in an Electronic Medical Record
Smith, D. H., Perrin, N., Feldstein, A. C., Yang, X., Kuang, D., Simon, S. R., Sittig, D. F., Platt, R. G., & Soumerai, S. B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1098 · Cited by 155 · see citing works
Self-citationTranslational cognition for decision support in critical care environments: A review
Patel, V. L., Zhang, J., Yoskowitz, N. A., Green, R., & Sayan, O. R. (2008) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.01.013 · Cited by 143 · see citing works
Sittig, D. F., Ash, J. S., Zhang, J., Osheroff, J. A., & Shabot, M. M. (2006) · Pediatrics · doi:10.1542/peds.2005-3132 · Cited by 130 · see citing works
Self-citationHolden, R. J., & Karsh, B.-T. (2009) · Behaviour & Information Technology · doi:10.1080/01449290601138245 · Cited by 128 · cited 1× · see citing works
“An ongoing challenge to the design, development, implementation and evaluation of health information technology (HIT) interventions is to operationalise their use within the complex adaptive healthcare system that consists of high-pressured, fast-paced and distributed settings of care delivery. Many conceptual models…”
BackgroundWhat is biomedical informatics?
Bernstam, E. V., Smith, J. W., & Johnson, T. R. (2009) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2009.08.006 · Cited by 128 · see citing works
Reducing Warfarin Medication Interactions
Feldstein, A. C., Smith, D. H., Perrin, N., Yang, X., Simon, S. R., Krall, M., Sittig, D. F., Ditmer, D., Platt, R. G., & Soumerai, S. B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.9.1009 · Cited by 122 · see citing works
Self-citationAdvances in Health Care Organization Theory
Mick, S. S. F., & Wyttenbach, M. E. (2003) · Journal for Healthcare Quality · doi:10.1097/01445442-200311000-00015 · Cited by 122 · see citing works
Pynoo, B., Devolder, P., Voet, T., Adang, L., Vercruysse, J., & Duyck, P. (2008) · Methods of Information in Medicine · doi:10.3414/me0477 · Cited by 111 · see citing works
The state of the art in clinical knowledge management: an inventory of tools and techniques
Sittig, D. F., Wright, A., Simonaitis, L., Carpenter, J. D., Allen, G. O., Doebbeling, B. N., Sirajuddin, A. M., Ash, J. S., & Middleton, B. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2009.09.003 · Cited by 101 · cited 1× · see citing works
“Certain elements of the clinical content, such as that which informs CDS interventions, must be managed on a regular basis.(36)”
BackgroundSelf-citationCohen, T., Blatter, B., Almeida, C., Shortliffe, E. H., & Patel, V. L. (2006) · Artificial Intelligence in Medicine · doi:10.1016/j.artmed.2006.03.009 · Cited by 96 · see citing works
Wright, A., Sittig, D. F., Ash, J. S., Bates, D. W., Feblowitz, J., Fraser, G., Maviglia, S. M., McMullen, C., Nichol, W. P., Pang, J. E., et al. (2011) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.2009.002030 · Cited by 92 · see citing works
Self-citationPersonal health records on the internet: a snapshot of the pioneers at the end of the 20th Century
Sittig, D. F. (2002) · International Journal of Medical Informatics · doi:10.1016/s1386-5056(01)00215-5 · Cited by 88 · see citing works
Self-citationEmotional Aspects of Computer-based Provider Order Entry: A Qualitative Study
Sittig, D. F. (2005) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1711 · Cited by 87 · see citing works
Self-citationEight Rights of Safe Electronic Health Record Use
Sittig, D. F. (2009) · JAMA · doi:10.1001/jama.2009.1311 · Cited by 85 · see citing works
Self-citationEight Recommendations for Policies for Communicating Abnormal Test Results
Singh, H., & Vij, M. S. (2010) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(10)36037-5 · Cited by 83 · see citing works
Self-citationHow to Design Computerized Alerts to Ensure Safe Prescribing Practices
Feldstein, A. C., Simon, S. R., Schneider, J. P., Krall, M., Laferriere, D. S., Smith, D. H., Sittig, D. F., & Soumerai, S. B. (2004) · The Joint Commission Journal on Quality and Safety · doi:10.1016/s1549-3741(04)30071-7 · Cited by 81 · see citing works
Self-citationUsability testing of mobile ICT for clinical settings: Methodological and practical challenges
Svanæs, D., Alsos, O. A., & Dahl, Y. (2008) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2008.06.014 · Cited by 80 · see citing works
Gosling, A. S. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1285 · Cited by 80 · see citing works
The Human Factors of Home Health Care
Henriksen, K., Joseph, A., & Zayas‐Cabán, T. (2009) · Journal of Patient Safety · doi:10.1097/pts.0b013e3181bd1c2a · Cited by 78 · see citing works
Safe Electronic Health Record Use Requires a Comprehensive Monitoring and Evaluation Framework
Sittig, D. F. (2010) · JAMA · doi:10.1001/jama.2010.61 · Cited by 76 · see citing works
Self-citationComputer Crash — Lessons from a System Failure
Kilbridge, P. (2003) · New England Journal of Medicine · doi:10.1056/nejmp030010 · Cited by 72 · cited 1× · see citing works
“For example, in 2002, the Beth Israel Deaconess Medical Center in Boston experienced a 4-day computer outage due to old, out-of-date computer equipment coupled with an outdated software programme designed to direct traffic on a much less complex network. Furthermore, their network diagnostic tools were ineffective bec…”
MethodProvider management strategies of abnormal test result alerts: a cognitive task analysis
Hysong, S. J., Sawhney, M. K., Wilson, L., Sittig, D. F., Espadas, D., Davis, T., & Singh, H. (2010) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m3200 · Cited by 65 · see citing works
Self-citationSingh, H., Wilson, L., Petersen, L. A., Sawhney, M. K., Reis, B., Espadas, D., & Sittig, D. F. (2009) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-9-49 · Cited by 64 · see citing works
Self-citationDetmer, D. E., Munger, B. S., & Lehmann, C. U. (2010) · Applied Clinical Informatics · doi:10.4338/aci-2009-11-r-0016 · Cited by 58 · see citing works
Advances In Industrial Ergonomics And Safety V
Nielson, R. B., & Jørgensen, K. M. (1993) · doi:10.1201/9780367804862 · Cited by 44 · see citing works
Ten Strategies to Improve Management of Abnormal Test Result Alerts in the Electronic Health Record
Singh, H., Wilson, L., Reis, B., Sawhney, M. K., Espadas, D., & Sittig, D. F. (2010) · Journal of Patient Safety · doi:10.1097/pts.0b013e3181ddf652 · Cited by 43 · see citing works
Self-citationHow the ICU follows orders: care delivery as a complex activity system.
(2003) · Europe PMC (PubMed Central) · Cited by 42 · see citing works
Self-citationComputer-based data entry for nurses in the ICU.
Bradshaw, K. E., Sittig, D. F., Gardner, R. M., Pryor, T. A., & Budd, M. (1989) · PubMed · Cited by 40 · see citing works
Self-citationImproving outpatient safety through effective electronic communication: a study protocol
Hysong, S. J., Sawhney, M. K., Wilson, L., Sittig, D. F., Esquivel, A., Watford, M., Giardina, T. D., Espadas, D., & Singh, H. (2009) · Implementation Science · doi:10.1186/1748-5908-4-62 · Cited by 34 · see citing works
Self-citationLeonard, K. J., & Sittig, D. F. (2007) · Journal of Medical Internet Research · doi:10.2196/jmir.9.2.e9 · Cited by 27 · see citing works
Self-citationLederman, R., & Parkes, C. (2005) · Journal of Medical Systems · doi:10.1007/s10916-005-1102-2 · Cited by 27 · see citing works
Sittig, D. F., Campbell, E. M., Guappone, K. P., Dykstra, R. H., & Ash, J. S. (2007) · PubMed Central · Cited by 24 · see citing works
Self-citationSittig, D. F., Shiffman, R. N., Leonard, K. J., Friedman, C. P., Rudolph, B. A., Hripcsak, G. M., Adams, L. L., Kleinman, L. C., & Kaushal, R. (2005) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-5-14 · Cited by 22 · see citing works
Self-citationHuman factors engineering for healthcare IT clinical applications
Beuscart-Zéphir, M.-C., Aarts, J. E. C. M., & Elkin, P. L. (2010) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2010.01.010 · Cited by 21 · see citing works
Monitoring the Monitor: Automated Statistical Tracking of a Clinical Event Monitor
Hripcsak, G. M. (1993) · Computers and Biomedical Research · doi:10.1006/cbmr.1993.1032 · Cited by 18 · see citing works
INDUSTRIAL ERGONOMIC FACTORS IN THE RADIATION ONCOLOGY THERAPY ENVIRONMENT
Henriksen, K., Kaye, R. D., & Morisseau, D. S. (1993) · CRC Press eBooks · doi:10.1201/9781482272413-38 · Cited by 11 · see citing works
Sheehan, B., Kaufman, D. R., Stetson, P. D., & Currie, L. M. (2009) · Europe PMC (PubMed Central) · Cited by 11 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [36]Sittig DF Wright A Simonaitis L Carpenter JD Allen GO Doebbeling BN Sirajuddin AM Ash JS Middleton B The state of the art in clinical knowledge management: an inventory of tools and techniques Int J Med Inform 2010 Jan 79 1 44 57 19828364 PMC2895508
Cited by
Sorted by citations
Security and privacy of electronic health records: Concerns and challenges
Keshta, I., & Odeh, A. (2021) · Egyptian Informatics Journal · doi:10.1016/j.eij.2020.07.003 · Cited by 498 · see citing works
Health IT and Patient Safety: Building Safer Systems for Better Care
Chou, D. (2012) · JAMA · doi:10.1001/jama.308.21.2282-a · Cited by 496 · see citing works
The impact of health information technology on patient safety
Alotaibi, Y. K., & Federico, F. A. (2017) · Saudi Medical Journal · doi:10.15537/smj.2017.12.20631 · Cited by 499 · see citing works
Kwan, J. L., Lo, L., Ferguson, J., Goldberg, H. R., Díaz-Martínez, J. P., TOMLINSON, G. A., Grimshaw, J., & Shojania, K. G. (2020) · BMJ · doi:10.1136/bmj.m3216 · Cited by 471 · see citing works
Bates, D. W., & Singh, H. (2018) · Health Affairs · doi:10.1377/hlthaff.2018.0738 · Cited by 456 · see citing works
Self-citationBack to the Future: Achieving Health Equity Through Health Informatics and Digital Health
Brewer, L. C., Fortuna, K. L., Jones, C., Walker, R., Hayes, S. N., Patten, C. A., & Cooper, L. A. (2020) · JMIR mHealth and uHealth · doi:10.2196/14512 · Cited by 367 · see citing works
The Global Burden of Diagnostic Errors in Primary Care
Singh, H., Schiff, G. D., Graber, M. L., Onakpoya, I., & Thompson, M. J. (2017) · BMJ Quality & Safety · doi:10.1136/bmjqs-2016-005401 · Cited by 395 · see citing works
Self-citationKilsdonk, E., Peute, L., & Jaspers, M. (2016) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2016.12.001 · Cited by 284 · see citing works
Fundamentals of Clinical Data Science
Kubben, P., Dumontier, M., & Dekker, A. L. A. J. (2018) · Springer eBooks · doi:10.1007/978-3-319-99713-1 · Cited by 240 · see citing works
Beyond TAM and UTAUT: Future directions for HIT implementation research
Shachak, A., Kuziemsky, C., & Petersen, C. (2019) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2019.103315 · Cited by 263 · see citing works
Report of the AMIA EHR-2020 Task Force on the status and future direction of EHRs
Payne, T. H., Corley, S., Cullen, T. A., Gandhi, T. K., Harrington, L., Kuperman, G. J., Mattison, J. E., McCallie, D. P., McDonald, C. J., Tang, P. C., et al. (2015) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv066 · Cited by 220 · see citing works
An analysis of electronic health record-related patient safety concerns
Meeks, D. W., Smith, M. W., Taylor, L., Sittig, D. F., Scott, J. M., & Singh, H. (2014) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-002578 · Cited by 207 · see citing works
Self-citationInformation Overload and Missed Test Results in Electronic Health Record–Based Settings
Singh, H., Spitzmueller, C., Petersen, N. J., Sawhney, M. K., & Sittig, D. F. (2013) · JAMA Internal Medicine · doi:10.1001/2013.jamainternmed.61 · Cited by 209 · see citing works
Self-citationElectronic health records and national patient-safety goals
Sittig, D. F., & Singh, H. (2012) · New England Journal of Medicine · doi:10.1056/nejmsb1205420 · Cited by 204 · see citing works
Self-citationAdvancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework
Singh, H., & Sittig, D. F. (2015) · BMJ Quality & Safety · doi:10.1136/bmjqs-2014-003675 · Cited by 201 · see citing works
Self-citationJames, H. M., Papoutsi, C., Wherton, J., Greenhalgh, T., & Shaw, S. E. (2021) · Journal of Medical Internet Research · doi:10.2196/23775 · Cited by 164 · see citing works
Beyond “implementation”: digital health innovation and service design
Shaw, J., Agarwal, P., Desveaux, L., Palma, D. C., Stamenova, V., Jamieson, T., Yang, R., Bhatia, R. S., & Bhattacharyya, O. K. (2018) · npj Digital Medicine · doi:10.1038/s41746-018-0059-8 · Cited by 187 · see citing works
Artificial intelligence in oncology: path to implementation
Chua, I. S., Gaziel‐Yablowitz, M., Korach, Z. T., Kehl, K. L., Levitan, N. A., Arriaga, Y. E., Jackson, G. P., Bates, D. W., & Hassett, M. (2021) · Cancer Medicine · doi:10.1002/cam4.3935 · Cited by 179 · see citing works
Bridging the implementation gap of machine learning in healthcare
Seneviratne, M. G., Shah, N. H., & Chu, L. (2020) · BMJ Innovations · doi:10.1136/bmjinnov-2019-000359 · Cited by 173 · see citing works
Patient portals and health apps: Pitfalls, promises, and what one might learn from the other
Baldwin, J. L., Singh, H., Sittig, D. F., & Giardina, T. D. (2016) · Healthcare · doi:10.1016/j.hjdsi.2016.08.004 · Cited by 179 · see citing works
Self-citationShaw, J., Jamieson, T., Agarwal, P., Griffin, B., Wong, I., & Bhatia, R. S. (2017) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17730444 · Cited by 177 · see citing works
Current challenges in health information technology–related patient safety
Sittig, D. F., Wright, A. T., Coiera, E. W., Magrabi, F., Ratwani, R. M., Bates, D. W., & Singh, H. (2018) · Health Informatics Journal · doi:10.1177/1460458218814893 · Cited by 173 · see citing works
Self-citationSingh, H., & Sittig, D. F. (2016) · BMJ Quality & Safety · doi:10.1136/bmjqs-2015-004486 · Cited by 167 · see citing works
Self-citationJacob, C., Sezgın, E., Sánchez-Vázquez, A., & Ivory, C. J. (2022) · JMIR mhealth and uhealth · doi:10.2196/36284 · Cited by 172 · see citing works
Defining Health Information Technology–Related Errors
Sittig, D. F. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.327 · Cited by 167 · see citing works
Self-citationPrivacy, confidentiality, security and patient safety concerns about electronic health records
Issa, W. B., Akour, I. A., Ibrahim, A., Marzouqi, A. M. A., Abbas, S., Hisham, F., & Griffiths, J. (2020) · International Nursing Review · doi:10.1111/inr.12585 · Cited by 168 · see citing works
Healthcare professionals' perceptions of digital health competence: A qualitative descriptive study
Jarva, E., Oikarinen, A., Andersson, J., Tuomikoski, A., Kääriäinen, M., Meriläinen, M. H., & Mikkonen, K. (2022) · Nursing Open · doi:10.1002/nop2.1184 · Cited by 160 · see citing works
Meyer, A. N. D., Giardina, T. D., Khawaja, L., & Singh, H. (2021) · Patient Education and Counseling · doi:10.1016/j.pec.2021.07.028 · Cited by 155 · see citing works
Self-citationHCI for health and wellbeing: Challenges and opportunities
Blandford, A. (2019) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2019.06.007 · Cited by 152 · see citing works
Lyratzopoulos, G., Vedsted, P., & Singh, H. (2015) · British Journal of Cancer · doi:10.1038/bjc.2015.47 · Cited by 154 · see citing works
Self-citationMeunier, P.-Y., Raynaud, C., Guimaraes, E., Gueyffier, F., & Letrilliart, L. (2023) · The Annals of Family Medicine · doi:10.1370/afm.2908 · Cited by 149 · see citing works
Kulikowski, C. A. (2019) · Yearbook of Medical Informatics · doi:10.1055/s-0039-1677895 · Cited by 144 · see citing works
“Models for the introduction of technologies in health care have been proposed [101] and the possibility that recurrent cycles of information technology improvements might help reduce potential harmful effects of IT disruptions has been discussed in the informatics literature [102].”
BackgroundSystem-related interventions to reduce diagnostic errors: a narrative review
Singh, H., Graber, M. L., KISSAM, S. M., Sorensen, A. V., Lenfestey, N. F., Tant, E. M., Henriksen, K., & LaBresh, K. A. (2011) · BMJ Quality & Safety · doi:10.1136/bmjqs-2011-000150 · Cited by 134 · see citing works
Self-citationpanel, G. E., de Velde, S. V., Kunnamo, I., Roshanov, P. S., Kortteisto, T., Aertgeerts, B., Vandvik, P. O., & Flottorp, S. A. (2018) · Implementation Science · doi:10.1186/s13012-018-0772-3 · Cited by 131 · see citing works
Analysis of clinical decision support system malfunctions: a case series and survey
Wright, A., Hickman, T.-T. T., McEvoy, D., Aaron, S., Ai, A., Andersen, J. M., Hussain, S., Ramoni, R., Fiskio, J., Sittig, D. F., et al. (2016) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw005 · Cited by 132 · see citing works
Self-citationUser-centered design to improve clinical decision support in primary care
Brunner, J., Chuang, E., Goldzweig, C. L., Cain, C., Sugar, C. A., & Yano, E. M. (2017) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2017.05.004 · Cited by 117 · see citing works
Patient perceptions of receiving test results via online portals: a mixed-methods study
Giardina, T. D., Baldwin, J. L., Nystrom, D. T., Sittig, D. F., & Singh, H. (2017) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocx140 · Cited by 117 · see citing works
Self-citationJacob, C., Sánchez-Vázquez, A., & Ivory, C. J. (2020) · JMIR mhealth and uhealth · doi:10.2196/18072 · Cited by 111 · see citing works
The unintended consequences of health information technology revisited
Ash, J., Berg, M., & Coiera, E. (2016) · Yearbook of Medical Informatics · doi:10.15265/iy-2016-014 · Cited by 101 · see citing works
Cresswell, K. M., Williams, R., & Sheikh, A. (2020) · Journal of Medical Internet Research · doi:10.2196/15068 · Cited by 112 · see citing works
A Socio-technical Approach to Preventing, Mitigating, and Recovering from Ransomware Attacks
Singh, H., & Sittig, D. F. (2016) · Applied Clinical Informatics · doi:10.4338/aci-2016-04-soa-0064 · Cited by 109 · see citing works
Self-citationChildhood cancer survivor care: development of the Passport for Care
Poplack, D. G., Fordis, M., Landier, W., Bhatia, R., Hudson, M. M., & Horowitz, M. E. (2014) · Nature Reviews Clinical Oncology · doi:10.1038/nrclinonc.2014.175 · Cited by 107 · see citing works
Philip, P., Dupuy, L., Auriacombe, M., Serre, F., de Sevin, É., Sauteraud, A., & Micoulaud‐Franchi, J. (2020) · npj Digital Medicine · doi:10.1038/s41746-019-0213-y · Cited by 105 · see citing works
Privacy in electronic health records: a systematic mapping study
da Silva, R. R. T., Antunes, N., & de Morais, A. H. F. (2023) · Journal of Public Health · doi:10.1007/s10389-022-01795-z · Cited by 121 · see citing works
Katurura, M., & Cilliers, L. (2018) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v10i1.1746 · Cited by 103 · see citing works
Exploring situational awareness in diagnostic errors in primary care
Singh, H., Giardina, T. D., Petersen, L. A., Smith, M. W., Paul, L. W., Dismukes, K., Bhagwath, G., & Thomas, E. J. (2011) · BMJ Quality & Safety · doi:10.1136/bmjqs-2011-000310 · Cited by 103 · see citing works
Self-citationElectronic Health Record–Related Events in Medical Malpractice Claims
Graber, M. L., Siegal, D., Riah, H., Johnston, D., & Kenyon, K. (2015) · Journal of Patient Safety · doi:10.1097/pts.0000000000000240 · Cited by 102 · see citing works
Development and initial evaluation of the Clinical Information Systems Success Model (CISSM)
García-Smith, D., & Effken, J. A. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2013.01.011 · Cited by 100 · see citing works
Tsou, A., Lehmann, C., Michel, J., Solomon, R., Possanza, L., & Gandhi, T. (2017) · Applied Clinical Informatics · doi:10.4338/aci-2016-09-r-0150 · Cited by 100 · see citing works
Sittig, D. F., Belmont, E., & Singh, H. (2017) · Healthcare · doi:10.1016/j.hjdsi.2017.06.004 · Cited by 103 · see citing works
Self-citationMeeks, D. W., Takian, A., Sittig, D. F., Singh, H., & Barber, N. (2014) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-001762 · Cited by 91 · see citing works
Self-citation“Artificial Intelligence” for Pharmacovigilance: Ready for Prime Time?
Ball, R., & Pan, G. J. D. (2022) · Drug Safety · doi:10.1007/s40264-022-01157-4 · Cited by 96 · see citing works
The Impact of Electronic Health Records on Diagnosis
Graber, M. L., Byrne, C., & Johnston, D. (2017) · Diagnosis · doi:10.1515/dx-2017-0012 · Cited by 108 · see citing works
Waterson, P. E. (2013) · Applied Ergonomics · doi:10.1016/j.apergo.2013.07.004 · Cited by 96 · see citing works
Singh, H., Spitzmueller, C., Petersen, N. J., Sawhney, M. K., Smith, M. W., Murphy, D. R., Espadas, D., Laxmisan, A., & Sittig, D. F. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001267 · Cited by 92 · see citing works
Self-citationAdus, S., Macklin, J. A., & Pinto, A. D. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-10098-2 · Cited by 99 · see citing works
Nguyen, O. T., Jenkins, N. J., Khanna, N., Shah, S., Gartland, A., Turner, K. L., & Merlo, L. J. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa339 · Cited by 97 · see citing works
Kumar, M., Gotz, D., Nutley, T., & Smith, J. B. (2017) · The International Journal of Health Planning and Management · doi:10.1002/hpm.2447 · Cited by 88 · see citing works
Shinners, L., Grace, S., Smith, S., Stephens, A. S., & Aggar, C. (2022) · Digital Health · doi:10.1177/20552076221078110 · Cited by 96 · see citing works
Artificial intelligence, nutrition, and ethical issues: A mini-review
Detopoulou, P., Voulgaridou, G., Moschos, P. N., Levidi, D., Anastasiou, T., Dedes, V., Diplari, E. M., Fourfouri, N., Giaginis, C., Panoutsopoulos, G. I., et al. (2023) · Clinical Nutrition Open Science · doi:10.1016/j.nutos.2023.07.001 · Cited by 94 · see citing works
Giardina, T. D., King, B. J., Ignaczak, A. P., Paull, D. E., Hoeksema, L. J., Mills, P. D., Neily, J. B., Hemphill, R. R., & Singh, H. (2013) · Health Affairs · doi:10.1377/hlthaff.2013.0130 · Cited by 85 · see citing works
Self-citationUse of Traumatic Brain Injury Prediction Rules With Clinical Decision Support
Dayan, P. S., Ballard, D. W., Tham, E., Hoffman, J. M., Swietlik, M., Deakyne, S., Alessandrini, E. A., Tzimenatos, L. S., Bajaj, L., Vinson, D. R., et al. (2017) · PEDIATRICS · doi:10.1542/peds.2016-2709 · Cited by 84 · see citing works
Building the evidence-base to reduce electronic health record–related clinician burden
Dymek, C., Kim, B. I., Melton, G. B., Payne, T. H., Singh, H., & Hsiao, C. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa238 · Cited by 83 · see citing works
Self-citationDeterminants of Intensive Care Unit Telemedicine Effectiveness: An Ethnographic Study
Kahn, J. M., Rak, K. J., Kuza, C. C., Ashcraft, L. E., Barnato, A. E., Fleck, J. C., Hershey, T. B., Hravnak, M., & Angus, D. C. (2018) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201802-0259oc · Cited by 82 · see citing works
Sheehan, B., Nigrovic, L. E., Dayan, P. S., Kuppermann, N., Ballard, D. W., Alessandrini, E. A., Bajaj, L., Goldberg, H., Hoffman, J., Offerman, S. R., et al. (2013) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2013.07.005 · Cited by 80 · see citing works
The emergence of new data work occupations in healthcare: The case of medical scribes
Bossen, C., Chen, Y., & Pine, K. H. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.01.001 · Cited by 80 · see citing works
Capturing the patient voice: implementing patient-reported outcomes across the health system
Austin, E. J., LeRouge, C., Hartzler, A. L., Segal, C. D., & Lavallee, D. C. (2019) · Quality of Life Research · doi:10.1007/s11136-019-02320-8 · Cited by 79 · see citing works
Health Disparities, Clinical Trials, and the Digital Divide
Adedinsewo, D. A., Eberly, L. A., Sokumbi, O., Rodriguez, J. A., Patten, C. A., & Brewer, L. C. (2023) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2023.05.003 · Cited by 91 · see citing works
Yen, P., McAlearney, A. S., Sieck, C. J., Hefner, J. L., & Huerta, T. R. (2017) · JMIR Medical Informatics · doi:10.2196/medinform.7476 · Cited by 80 · see citing works
Talal, A. H., Sofikitou, E. M., Jaanimägi, U., Zeremski, M., Tobin, J. N., & Markatou, M. (2020) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2020.103622 · Cited by 81 · see citing works
Singh, H., & Sittig, D. F. (2020) · Annals of Internal Medicine · doi:10.7326/m19-0879 · Cited by 77 · see citing works
Self-citationEmerging Technologies for Identifying Atrial Fibrillation
Ding, E., Marcus, G. M., & McManus, D. D. (2020) · Circulation Research · doi:10.1161/circresaha.119.316342 · Cited by 77 · see citing works
Martin, G., Koizia, L. J., Kooner, A. S., Cafferkey, J., Ross, C., Purkayastha, S., Sivananthan, A., Tanna, A., Pratt, P., Kinross, J. K., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/21486 · Cited by 75 · see citing works
Checking the Lists: A Systematic Review of Electronic Checklist Use in Health Care
Kramer, H. S., & Drews, F. A. (2017) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2016.09.006 · Cited by 75 · see citing works
Kushniruk, A. W., Bates, D. W., Bainbridge, M., Househ, M. S., & Borycki, E. M. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.12.006 · Cited by 74 · see citing works
Telehealth was beneficial during COVID ‐19 for older Americans: A qualitative study with physicians
Goldberg, E. M., Jiménez, F. N., Chen, K., Davoodi, N. M., Li, M. M., Strauss, D. H., Zou, M., Guthrie, K. M., & Merchant, R. C. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17370 · Cited by 72 · see citing works
Sittig, D. F., Ash, J. S., & Singh, H. (2014) · PubMed · Cited by 72 · see citing works
Self-citationSittig, D. F., Gonzalez, D., & Singh, H. (2014) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2014.07.007 · Cited by 70 · see citing works
Self-citationOpportunities for genomic clinical decision support interventions
Overby, C. L., Kohane, I. S., Kannry, J. L., Williams, M. S., Starren, J. B., Böttinger, E. P., Gottesman, O., Denny, J. C., Weng, C., Tarczy-Hornoch, P. Z., et al. (2013) · Genetics in Medicine · doi:10.1038/gim.2013.128 · Cited by 70 · see citing works
Nurses’ Experience With Health Information Technology: Longitudinal Qualitative Study
Zadvinskis, I. M., Smith, J. G., & Yen, P. (2018) · JMIR Medical Informatics · doi:10.2196/medinform.8734 · Cited by 70 · see citing works
Hsiao, C., Dymek, C., Kim, B. I., & Russell, B. (2019) · Quality of Life Research · doi:10.1007/s11136-019-02112-0 · Cited by 68 · see citing works
Grappling with the future: The messiness of pilot implementation in information systems design
Hertzum, M., Manikas, M. I., & Torkilsheyggi, A. M. Á. (2017) · Health Informatics Journal · doi:10.1177/1460458217712058 · Cited by 68 · see citing works
Technology entrepreneurship in healthcare: Challenges and opportunities for value creation
Kulkov, I., Ivanova-Gongne, M., Bertello, A., Makkonen, H. S., Kulkova, J., Rohrbeck, R., & Ferraris, A. (2023) · Journal of Innovation & Knowledge · doi:10.1016/j.jik.2023.100365 · Cited by 66 · see citing works
AI Scribes in Health Care: Balancing Transformative Potential With Responsible Integration
Leung, T. I., Coristine, A. J., & Benis, A. (2025) · JMIR Medical Informatics · doi:10.2196/80898 · Cited by 67 · see citing works
Terry, A. L., Kueper, J. K., Beleno, R., Brown, J. B., Cejic, S., Dang, J., Leger, D., McKay, S., Meredith, L., Pinto, A. D., et al. (2022) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-022-01984-6 · Cited by 64 · see citing works
Wilson, P. M., Ramar, P., Philpot, L. M., Soleimani, J., Ebbert, J. O., Storlie, C. B., Morgan, A. A., Schaeferle, G. M., Asai, S. W., Herasevich, V., et al. (2023) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2023.02.317 · Cited by 63 · see citing works
Liu, K., Or, C. K., So, M. K. P., Cheung, B. M. Y., Chan, B. K. P., Tiwari, A., & Tan, J. (2021) · Applied Ergonomics · doi:10.1016/j.apergo.2021.103667 · Cited by 62 · see citing works
Landman, A., Emani, S., Carlile, N., Rosenthal, D., Guelich, S., Semakov, S., Pallin, D. J., & Poon, E. G. (2015) · JMIR mhealth and uhealth · doi:10.2196/mhealth.3481 · Cited by 61 · see citing works
Integrated acceptance and sustainability evaluation of Internet of Medical Things
Shin, D., & Hwang, Y. (2017) · Internet Research · doi:10.1108/intr-07-2016-0200 · Cited by 60 · see citing works
Dalal, A. K., Fuller, T. E., Garabedian, P., Ergai, A., Balint, C., Bates, D. W., & Benneyan, J. C. (2019) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz002 · Cited by 58 · see citing works
The biopsychosociotechnical model: a systems-based framework for human-centered health improvement
Card, A. J. (2022) · Health Systems · doi:10.1080/20476965.2022.2029584 · Cited by 66 · see citing works
Improving the Effectiveness of Electronic Health Record-Based Referral Processes
Esquivel, A., Sittig, D. F., Murphy, D. R., & Singh, H. (2012) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-12-107 · Cited by 57 · see citing works
Self-citationWright, A., Sittig, D. F., Ash, J. S., Erickson, J. L., Hickman, T. T., Paterno, M., Gebhardt, E., McMullen, C., Tsurikova, R., Dixon, B. E., et al. (2015) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2015.08.008 · Cited by 55 · see citing works
Self-citationShaw, S. E., Hughes, G., Wherton, J. P., Moore, L., Rosen, R., Papoutsi, C., Rushforth, A., Morris, J. H., Wood, G. W., Faulkner, S. D., et al. (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2021.754319 · Cited by 53 · see citing works
Usability evaluation of a commercial inpatient portal
Yen, P., Walker, D. M., Smith, J. G., Zhou, M. P., Menser, T. L., & McAlearney, A. S. (2017) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2017.11.007 · Cited by 54 · see citing works
Murphy, D. R., Satterly, T., Giardina, T. D., Sittig, D. F., & Singh, H. (2019) · Journal of General Internal Medicine · doi:10.1007/s11606-019-05112-5 · Cited by 55 · see citing works
Self-citationLanham, H. J., Sittig, D. F., Leykum, L. K., Parchman, M. L., Pugh, J. A., & McDaniel, R. R. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001377 · Cited by 52 · see citing works
Self-citationOr, C. K., Dohan, M. S., & Tan, J. (2014) · Journal of Medical Systems · doi:10.1007/s10916-014-0099-9 · Cited by 53 · see citing works
Khalifa, M., Magrabi, F., & Gallego, B. (2019) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-019-0940-7 · Cited by 54 · see citing works
The contribution of sociotechnical factors to health information technology-related sentinel events
Castro, G. M., Buczkowski, L., & Hafner, J. M. (2016) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(16)42008-8 · Cited by 48 · see citing works
- Authors
- Sittig, D. F., & Singh, H.
- Affiliations
- Memorial Hermann (US)
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Sittig, D. F.
- Venue
- Quality and Safety in Health Care
- Publisher
- BMJ
- Published
- 2010-10-01
- Volume
- 19
- Issue
- Suppl 3
- Pages
- i68-i74
- ISSN
- 1475-3898 (ISSN-L)
- 1475-3901
- PMC
- PMC3120130
- OpenAlex
- W2110034024
- Cited by
- 897
- References
- 64
- Citations by year
- 2026: 179 · 2025: 91 · 2024: 43 · 2023: 75 · 2022: 58 · 2021: 66 · 2020: 52 · 2019: 70 · 2018: 40 · 2017: 48 · 2016: 41 · 2015: 36 · 2014: 36 · 2013: 34 · 2012: 15
- FWCI
- 36.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Health Services Research and Development
- National Institutes of Health
- Agency for Healthcare Research and Quality (R18HS017820)
- VA National Center for Patient Safety
- National Cancer Institute (K23CA125585)
- U.S. National Library of Medicine (R01LM006942, R56LM006942)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Sociology and Political Science › 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, socio-technical model, complex adaptive systems, health care system, clinical workflow, human-machine interaction, organizational culture, health policy and regulation, monitoring and measurement, unintended consequences
- MeSH terms
- Diffusion of Innovation, Health Services Research, Humans, Ergonomics, Medical Informatics, Models, Theoretical, Planning Techniques, Programming Languages, Software Design, User-Computer Interface, Organizational Culture, Organizational Policy, Workflow
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
