ArticleJournal of the American Medical Informatics Association : JAMIA
An analysis of electronic health record-related patient safety concerns.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03855735 ("Sufficiency, Accuracy, Clarity, Contextualization, and Interpersonal Adaptation - Safe, Digitally Supported Communication in Gynecology and Obstetrics), which is not on this map. Cited by 79 papers, 3 of them syntheses that pooled it.
What it found
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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.
"Sufficiency, Accuracy, Clarity, Contextualization, and Interpersonal Adaptation - Safe, Digitally Supported Communication in Gynecology and Obstetrics: TeamBaby"
Who cites it
79 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Information Quality Frameworks for Digital Health Technologies: Systematic Review.Journal of medical Internet research · 2021Pooled it
- Are We There Yet? Human Factors Knowledge and Health Information Technology - the Challenges of Implementation and Impact.Yearbook of medical informatics · 2017Pooled it
- Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- The Real "Catch" in Clinical Automation: Rethinking Artificial Intelligence for Healthcare Workflows.Cureus · 2026Article
- Why health information technology safety problems remain invisible.Frontiers in digital health · 2026Article
- Challenges and Opportunities in the Medication Reconciliation Process in an Emergency Department: An Observational Human Factors Study.Journal of patient safety · 2025Observational
- The evolution of patient-reported safety concerns during the COVID-19 pandemic within a series of study questionnaires: a multi-method analysis.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- A Novel Framework to Assess Clinical Information in Digital Health Technologies: Cross-Sectional Survey Study.JMIR medical informatics · 2025Article
- Development and Validation of Natural Language Processing Algorithms in the ENACT National Electronic Health Record Research Network.medRxiv : the preprint server for health sciences · 2025Article
- A simulation study to quantitatively assess the performance of electronic prescribing systems in English NHS Hospital Trusts.Scientific reports · 2025Article
- Development and validation of natural language processing algorithms in the national ENACT network.Journal of clinical and translational science · 2025Article
- Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure.BMC health services research · 2024Article
- Implementation of a health information technology safety classification system in the Veterans Health Administration's Informatics Patient Safety Office.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Development of minimum data set and dashboard for monitoring adverse events in radiology departments.Heliyon · 2024Article
- Assessing the Usability and Feasibility of Digital Assistant Tools for Direct Support Professionals: Participatory Design and Pilot-Testing.JMIR human factors · 2024Article
- Operational disruption in healthcare associated with software functionality issue due to software security patching: a case report.Frontiers in digital health · 2024Article
- Limitations in the use of automated mental status detection for clinical decision support.International journal of medical informatics · 2023Article
- "Everything's so Role-Specific": VA Employee Perspectives' on Electronic Health Record (EHR) Transition Implications for Roles and Responsibilities.Journal of general internal medicine · 2023Article
- Characterization of Safety Events Involving Technology in Primary and Community Care.Applied clinical informatics · 2023Article
- The biopsychosociotechnical model: a systems-based framework for human-centered health improvement.Health systems (Basingstoke, England) · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveA recent Institute of Medicine report called for attention to safety issues related to electronic health records (EHRs). We analyzed EHR-related safety concerns reported within a large, integrated healthcare system.
methodsThe Informatics Patient Safety Office of the Veterans Health Administration (VA) maintains a non-punitive, voluntary reporting system to collect and investigate EHR-related safety concerns (ie, adverse events, potential events, and near misses). We analyzed completed investigations using an eight-dimension sociotechnical conceptual model that accounted for both technical and non-technical dimensions of safety. Using the framework analysis approach to qualitative data, we identified emergent and recurring safety concerns common to multiple reports.
resultsWe extracted 100 consecutive, unique, closed investigations between August 2009 and May 2013 from 344 reported incidents. Seventy-four involved unsafe technology and 25 involved unsafe use of technology. A majority (70%) involved two or more model dimensions. Most often, non-technical dimensions such as workflow, policies, and personnel interacted in a complex fashion with technical dimensions such as software/hardware, content, and user interface to produce safety concerns. Most (94%) safety concerns related to either unmet data-display needs in the EHR (ie, displayed information available to the end user failed to reduce uncertainty or led to increased potential for patient harm), software upgrades or modifications, data transmission between components of the EHR, or 'hidden dependencies' within the EHR. DISCUSSION: EHR-related safety concerns involving both unsafe technology and unsafe use of technology persist long after 'go-live' and despite the sophisticated EHR infrastructure represented in our data source. Currently, few healthcare institutions have reporting and analysis capabilities similar to the VA.
conclusionsBecause EHR-related safety concerns have complex sociotechnical origins, institutions with long-standing as well as recent EHR implementations should build a robust infrastructure to monitor and learn from them.
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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.