ArticleJournal of the American Medical Informatics Association : JAMIA2014
Exploring the sociotechnical intersection of patient safety and electronic health record implementation.
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 35 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials.BMJ (Clinical research ed.) · 2020Pooled 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
- Automated Waitlists for Ambulatory Appointment Scheduling: Multisite, Mixed Methods Evaluation.Journal of medical Internet research · 2026Article
- An exploratory mixed-methods study using the ELICIT framework to identify stakeholder-informed implementation strategies for a population health platform.BMC health services research · 2026Article
- When better data meets better design: How EHR data usability and system usability shape physicians' cognitive load.NPJ digital medicine · 2026Article
- Sociotechnical Needs of Registered Nurses in the Heart Failure Hospitalizations of African American Patients: Cross-Sectional Study.JMIR nursing · 2025Observational
- Clinical Informatics Team Members' Perspectives on Health Information Technology Safety After Experiential Learning and Safety Process Development: Qualitative Descriptive Study.JMIR formative research · 2024Article
- Medication Safety Amid Technological Change: Usability Evaluation to Inform Inpatient Nurses' Electronic Health Record System Transition.Journal of general internal medicine · 2023Article
- Characterization of Safety Events Involving Technology in Primary and Community Care.Applied clinical informatics · 2023Article
- Association between Electronic Health Record Implementations and Hospital-Acquired Conditions in Pediatric Hospitals.Applied clinical informatics · 2023Article
- Prospects of Hospital Information Systems and Patient Safety in Japan.Healthcare informatics research · 2022Article
- Sixteen years of eHealth experiences in Iran: a qualitative content analysis of national policies.Health research policy and systems · 2021Article
- Evaluating Simplified Web Interfaces of Risk Models for Clinical Use: Pilot Survey Study.JMIR formative research · 2021Article
- Enabling adoption and use of new health information technology during implementation: Roles and strategies for internal and external support personnel.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- A Sociotechnical Approach to Analyze Pharmaceutical Policy and Services Management in Primary Health Care in a Brazilian Municipality.Pharmacy (Basel, Switzerland) · 2021Article
- Perceptual Gaps Between Clinicians and Technologists on Health Information Technology-Related Errors in Hospitals: Observational Study.JMIR human factors · 2021Article
- Staff expectations for the implementation of an electronic health record system: a qualitative study using normalisation process theory.BMC medical informatics and decision making · 2019Article
- Developing a framework for evidence-based grading and assessment of predictive tools for clinical decision support.BMC medical informatics and decision making · 2019Review
- Improving the Effectiveness of Health Information Technology: The Case for Situational Analytics.Applied clinical informatics · 2019Article
- Systems engineering and human factors support of a system of novel EHR-integrated tools to prevent harm in the hospital.Journal of the American Medical Informatics Association : JAMIA · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveThe intersection of electronic health records (EHR) and patient safety is complex. To examine the applicability of two previously developed conceptual models comprehensively to understand safety implications of EHR implementation in the English National Health Service (NHS).
methodsWe conducted a secondary analysis of interview data from a 30-month longitudinal, prospective, case study-based evaluation of EHR implementation in 12 NHS hospitals. We used a framework analysis approach to apply conceptual models developed by Sittig and Singh to understand better EHR implementation and use: an eight-dimension sociotechnical model and a three-phase patient safety model (safe technology, safe use of technology, and use of technology to improve safety).
resultsThe intersection of patient safety and EHR implementation and use was characterized by risks involving technology (hardware and software, clinical content, and human-computer interfaces), the interaction of technology with non-technological factors, and improper or unsafe use of technology. Our data support that patient safety improvement activities as well as patient safety hazards change as an organization evolves from concerns about safe EHR functionality, ensuring safe and appropriate EHR use, to using the EHR itself to provide ongoing surveillance and monitoring of patient safety. DISCUSSION: We demonstrate the face validity of two models for understanding the sociotechnical aspects of safe EHR implementation and the complex interactions of technology within a healthcare system evolving from paper to integrated EHR.
conclusionsUsing sociotechnical models, including those presented in this paper, may be beneficial to help stakeholders understand, synthesize, and anticipate risks at the intersection of patient safety and health information technology.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.