Human Factors in Telemedicine

EHR‐related medication errors in two ICUs

“…For example, in the larger study, we found that duplicate medication errors increased after EHR implementation, and contributing factors related to this increase included the EHR design as well as task‐related changes during physician rounding (eg, multiple persons entering orders for the same patient at the same time) and organization‐related changes in handoff communication with duplicate orders placed before and after change of shift . These complexities demonstrate the need for a sociotechnical systems approach such as the Systems Engineering Initiative for Patient Safety (SEIPS) model to systematically address EHR safety . A recent review of the literature on EHR safety, organized according to the SEIPS model, found factors contributing to EHR safety in each element of the work system.…”

“…Therefore, we need to not only design the technology appropriately (eg, usability of interface), but also evaluate the fit of the technology with the rest of the work system . We also need to develop, implement, and evaluate organizational processes aimed at identifying EHR‐related safety problems after technology implementation; this fits the human factors engineering concept of continuous adaptation and improvement of work systems . We actually implemented this principle as we presented preliminary results on medication errors to the participating organization; this occurred within 1 year of the EHR implementation.…”