The unintended consequences of health information technology revisited
Open accessAbstract
Summary: Introduction: The introduction of health information technology into clinical settings is associated with unintended negative consequences, some with the potential to lead to error and patient harm. As adoption rates soar, the impact of these hazards will increase. Objective: Over the last decade, unintended consequences have received great attention in the medical informatics literature, and this paper seeks to identify the major themes that have emerged. Results: Rich typologies of the causes of unintended consequences have been developed, along with a number of explanatory frameworks based on socio-technical systems theory. We however still have only limited data on the frequency and impact of these events, as most studies rely on data sets from incident reporting or patient chart reviews, rather than undertaking detailed observational studies. Such data are increasingly needed as more organizations implement health information technologies. When outcome studies have been done in different organizations, they reveal different outcomes for identical systems. From a theoretical perspective, recent advances in the emerging discipline of implementation science have much to offer in explaining the origin, and variability, of unintended consequences. Conclusion: The dynamic nature of health care service organizations, and the rapid development and adoption of health information technologies means that unintended consequences are unlikely to disappear, and we therefore must commit to developing robust systems to detect and manage them.
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Documentation burden associated with electronic health records is linked to clinician burnout among physicians and nurses.
“Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout.”
From Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review (2021) · cites this paper as [3]
The 'Unintended Consequences of Clinical Decision-Support Systems' section (page unavailable) lists 'more/new work for clinicians' among the consequences of computerized provider order entry. It does not identify that work as EHR documentation burden or link it to burnout among physicians or nurses. (LLM, conf=0.82)
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- Authors
- Ash, J., Berg, M., & Coiera, E.
- Affiliations
- KPMG (United States) (US)
- Macquarie University (AU)
- Corresponding author
- Coiera, E.
- ORCID
- Venue
- Yearbook of Medical Informatics
- Publisher
- Georg Thieme Verlag KG
- Published
- 2016-08
- Volume
- 25
- Issue
- 01
- Pages
- 163-169
- ISSN
- 0943-4747 (ISSN-L)
- 2364-0502
- PMC
- PMC5171576
- OpenAlex
- W2554844626
- Cited by
- 101
- References
- 62
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 14 · 2023: 10 · 2022: 13 · 2021: 18 · 2020: 12 · 2019: 12 · 2018: 8 · 2017: 2 · 2016: 1
- FWCI
- 13.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Yearbook of Medical Informatics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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 › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- health information technology, unintended consequences, patient safety, medical errors, patient harm, socio-technical systems theory, implementation science, incident reporting, health care organization, technology adoption
- MeSH terms
- Cognition, Humans, Medical Informatics, Risk Management, User-Computer Interface, Electronic Health Records
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