ArticleJournal of the American Medical Informatics Association : JAMIA2014
A typology of electronic health record workarounds in small-to-medium size primary care practices.
Article in Journal of the American Medical Informatics Association : JAMIA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- Are We There Yet? Human Factors Knowledge and Health Information Technology - the Challenges of Implementation and Impact.Yearbook of medical informatics · 2017Pooled it
- Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.Applied clinical informatics · 2016Pooled it
- Inefficient Processes and Associated Factors in Primary Care Nursing: System Configuration Analysis.JMIR human factors · 2024Article
- Benefits, facilitators, and barriers of electronic medical records implementation in outpatient settings: A scoping review.Healthcare management forum · 2024Article
- Electronic Health Records' Support for Primary Care Physicians' Situation Awareness: A Metanarrative Review.Human factors · 2023Review
- Real-world utilization of SARS-CoV-2 serological testing in RNA positive patients across the United States.PloS one · 2023Article
- Workarounds in Electronic Health Record Systems and the Revised Sociotechnical Electronic Health Record Workaround Analysis Framework: Scoping Review.Journal of medical Internet research · 2022Article
- Designing a reference architecture for health information systems.BMC medical informatics and decision making · 2021Article
- Persisting workarounds in Electronic Health Record System use: types, risks and benefits.BMC medical informatics and decision making · 2021Article
- Why Is the Electronic Health Record So Challenging for Research and Clinical Care?Methods of information in medicine · 2021Article
- Electronic health records and clinician burnout: A story of three eras.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Automatic classification of scanned electronic health record documents.International journal of medical informatics · 2020Article
- Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs.Journal of the American Medical Informatics Association : JAMIA · 2020Observational
- Impacts of Operational Failures on Primary Care Physicians' Work: A Critical Interpretive Synthesis of the Literature.Annals of family medicine · 2020Review
- Technology barriers and strategies in coordinating care for chronically ill patients.Applied ergonomics · 2019Article
- An exploration of workarounds and their perceived impact on antibiotic stewardship in the adult medical wards of a referral hospital in Malawi: a qualitative study.BMC health services research · 2019Article
- Challenges And Opportunities For Improving Patient Safety Through Human Factors And Systems Engineering.Health affairs (Project Hope) · 2018Article
- Primary Care Practices' Abilities And Challenges In Using Electronic Health Record Data For Quality Improvement.Health affairs (Project Hope) · 2018Article
- Workarounds Emerging From Electronic Health Record System Usage: Consequences for Patient Safety, Effectiveness of Care, and Efficiency of Care.JMIR human factors · 2017Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveElectronic health record (EHR) use in ambulatory care can improve safety and quality; however, problems with design, implementation, and poor interface with other systems lead users to develop 'workarounds', or behaviors users adopt to overcome perceived limitations in a technical system. We documented workarounds used in independent, community-based primary care practices, and developed a typology of their key features. MATERIALS AND
methodsComparative case study of EHR use in seven independent primary care practices. Field researchers spent approximately 1 month in each practice to observe EHR use, conduct patient pathways, and interview clinicians and staff.
resultsWe observed workarounds addressing a wide range of EHR-related problems, including: user interface issues (eg, insufficient data fields, limited templates), barriers to electronic health information exchange with external organizations, and struggles incorporating new technologies into existing office space. We analyzed the observed workarounds inductively to develop a typology that cuts across specific clinical or administrative processes to highlight the following key formal features of workarounds in general: temporary/routinized, which captures whether the workaround is taken for granted as part of daily workflow or is understood as a short-term solution; avoidable/unavoidable, referring to the extent to which the workaround is within the practice's power to eliminate; and deliberately chosen/unplanned, which differentiates strategically chosen adaptations from less thoughtful workarounds.
conclusionsThis workaround typology provides a framework for EHR users to identify and address workarounds in their own practices, and for researchers to examine the effect of different types of EHR workarounds on patient safety, care quality, and efficiency.
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