Essential activities for electronic health record safety: A qualitative study
Open accessAbstract
Electronic health record-caused safety risks are an unintended consequence of the implementation of clinical systems. To identify activities essential to assuring that the electronic health record is managed and used safely, we used the Rapid Assessment Process, a collection of qualitative methods. A multidisciplinary team conducted visits to five healthcare sites to learn about best practices. Although titles and roles were very different across sites, certain tasks considered necessary by our subjects were remarkably similar. We identified 10 groups of activities/tasks in three major areas. Area A, decision-making activities, included overseeing, planning, and reviewing to assure electronic health record safety. Area B, organizational learning activities, involved monitoring, testing, analyzing, and reporting. Finally, Area C, user-related activities, included training, communication, and building clinical decision support. To minimize electronic health record-related patient safety risks, leaders in healthcare organizations should ensure that these essential activities are performed.
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Cognitive load must be managed for effective problem-solving and clinical decision-making, as levels of cognitive load influence decisions and outcomes.
“Cognitive load must be managed for effective problem-solving and clinical decision-making (correct decisions/reduction of errors), as levels of cognitive load influence decisions and outcomes38,49–53.”
From When better data meets better design: How EHR data usability and system usability shape physicians' cognitive load (2026) · cites this paper as [52]
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- Authors
- Ash, J. S., Singh, H., Wright, A., Chase, D., & Sittig, D. F.
- Affiliations
- Oregon Health & Science University (US)
- Michael E. DeBakey VA Medical Center (US)
- Harvard University (US)
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Ash, Joan S
- Venue
- Health Informatics Journal
- Publisher
- SAGE Publications
- Published
- 2019-03-08
- Volume
- 26
- Issue
- 4
- Pages
- 3140-3151
- ISSN
- 1355-4743 (ISSN-L)
- 1460-4582
- 1741-2811
- OpenAlex
- W2920860815
- Cited by
- 12
- References
- 21
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- green
- doaj.org
- Locations
- Health Informatics Journal (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Office of the National Coordinator for Health Information Technology (This project was supported through a subcontract f)
- health services research and development ((CIN13-413))
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, patient safety, clinical decision support, organizational learning, safety supervision, user training, healthcare leadership
- MeSH terms
- Communication, Humans, Decision Support Systems, Clinical, Qualitative Research, Electronic Health Records, Patient Safety
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