EHR‐related medication errors in two ICUs

Carayon, Pascale; Du, Shimeng; Brown, Roger; Cartmill, Randi; Johnson, Mark; Wetterneck, Tosha B.

doi:10.1002/jhrm.21259

Cited by 35 publications

(19 citation statements)

References 45 publications

(93 reference statements)

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“…The alarming statistic of this study is that 19% of the EHR usability-related events could have resulted in patient harm. A prospective study of medication safety among 624 patients in two ICUs of a medical center identified a total of1,622 preventable adverse drug events after EHR implementation 14 . Thirty-four percent of medication events were related to EHR technology; they included orders with missing information and accepted duplicate medication orders.…”

Section: Usability Problems Of Health It and Their Negative Impact mentioning

confidence: 99%

Human Factors and Usability for Health Information Technology: Old and New Challenges

2019

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Objectives: Despite national mandates, incentives, and other programs, the design of health information technology (IT) remains problematic and usability problems continue to be reported. This paper reviews recent literature on human factors and usability of health IT, with a specific focus on research aimed at applying human factors methods and principles to improve the actual design of health IT, its use, and associated patient and clinician outcomes. Methods: We reviewed recent literature on human factors and usability problems of health IT and research on human-centered design of health IT for clinicians and patients. Results: Studies continue to show usability problems of health IT experienced by multiple groups of health care professionals (e.g., physicians and nurses) as well as patients. Recent research shows that usability is influenced by both designers (e.g., IT vendors) and implementers in health care organizations, and that the application of human-centered design practices needs to be further improved and extended. We welcome emerging research on the design of health IT for teams as team-based care is increasingly implemented throughout health care. Conclusions: Progress in the application of human factors methods and principles to the design of health IT is occurring, with important information provided on their actual impact on care processes and patient outcomes. Future research should examine the work of health IT designers and implementers, which would help to develop strategies for further embedding human factors engineering in IT design processes.

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Section: Usability Problems Of Health It and Their Negative Impact mentioning

confidence: 99%

Human Factors and Usability for Health Information Technology: Old and New Challenges

2019

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“…Current studies on tEMR use in pharmacy education do not report using any adapted models or frameworks to guide information technology acceptance. Although it is known that EMRs impact the medication use process, best practices for incorporating EMRs into pharmacy practice and preparing students for future careers are currently unknown [17,18]. Since pharmacy students are an integral part of the healthcare system and EMRs are ubiquitous in healthcare today, we conducted a study to gain a better understanding of pharmacy students' early experience with a tEMR.…”

Section: Introductionmentioning

confidence: 99%

Pharmacy students’ perspectives on the initial implementation of a teaching electronic medical record: results from a mixed-methods assessment

et al. 2020

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Background: Electronic medical records (EMRs) have been used for nearly three decades. Pharmacists use EMRs on a daily basis, but EMRs have only recently been incorporated into pharmacy education. Some pharmacy programs have implemented teaching electronic medical records (tEMRs), but best practices for incorporating tEMRs into pharmacy education remain unknown. The objectives of this study were to 1) assess pharmacy students' views and experiences with a tEMR; and 2) identify current learning activities and future priorities for tEMR use in pharmacy education.Methods: We used a mixed-methods approach, including three, two-hour student focus groups and a 42-item web-based survey to examine student perspectives of the tEMR. All first, second, and third year professional pharmacy students were eligible to participate in the survey and a focus group. Web-based survey items were measured on a 7-point Likert scale, and quantitative analyses included descriptive statistics. Two researchers independently coded transcripts using both deductive and inductive approaches to identify emergent themes. These analysts met and resolved any coding discrepancies via consensus.Results: Focus groups were conducted with 22 total students, with 6-8 students represented from each year of pharmacy training. The survey was completed by 156 students: 47 first year, 55 second year, and 54 third year. Overall, 48.7% of survey respondents altogether agreed or strongly agreed that using the tEMR enhanced their learning in pharmacy classes and laboratories. Qualitative data were organized into four major themes regarding tEMR adoption: current priorities for use within the pharmacy curriculum; tEMR benefits; tEMR barriers; and future priorities for tEMR use to prepare students for pharmacy practice.

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“…Although significant research has shown the value of HF/SE in improving the design of technologies, such as smart infusion pump and subsequent medication safety,(22, 45, 46) patient safety problems continue to occur related to poor HF design and technology implementation. (47, 48) Significant work remains to more systematically integrate HF/SE (e.g. usability) in designing health information technologies,(49) in particular among vendors,(50) including training of designers and implementers in human-centered design.…”

Section: Introductionmentioning

confidence: 99%

Challenges And Opportunities For Improving Patient Safety Through Human Factors And Systems Engineering

et al. 2018

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Despite progress on patient safety since the Institute of Medicine 1999 report “To Err is Human”, significant problems remain. Human factors and systems engineering (HF/SE) has been increasingly recognized and advocated for its value in understanding, improving, and redesigning processes for safer care, especially for complex interacting sociotechnical systems. Broad awareness and adoption of HF/SE into safety improvement work, however, has been frustratingly slow. We provide an overview of HF/SE, its demonstrated value to a wide range of patient safety problems, in particular medication safety, and challenges to its broader implementation across health care. We propose seven recommendations and policy implications to maximize the spread of HF/SE, including formal and informal education programs, greater adoption of HF/SE by healthcare organizations, expanded funding to foster greater clinician-engineer partnerships, and coordinated national efforts to design and operationalize a system for spreading HF/SE into health care nationally.

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EHR‐related medication errors in two ICUs

Cited by 35 publications

References 45 publications

Human Factors and Usability for Health Information Technology: Old and New Challenges

Human Factors and Usability for Health Information Technology: Old and New Challenges

Pharmacy students’ perspectives on the initial implementation of a teaching electronic medical record: results from a mixed-methods assessment

Challenges And Opportunities For Improving Patient Safety Through Human Factors And Systems Engineering

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