Categorizing the unintended sociotechnical consequences of computerized provider order entry

Joan S. Ash; Dean F. Sittig; Richard H. Dykstra; Kenneth Guappone; James D. Carpenter; Veena Seshadri

doi:10.1016/j.ijmedinf.2006.05.017

Categorizing the unintended sociotechnical consequences of computerized provider order entry

Joan S. Ash
, Dean F. Sittig
, Richard H. Dykstra
, Kenneth Guappone
, James D. Carpenter
, Veena Seshadri

Medical Informatics and Clinical Epidemiology

Research output: Contribution to journal › Article › peer-review

231 Scopus citations

Abstract

Objective: To describe the kinds of unintended consequences related to the implementation of computerized provider order entry (CPOE) in the outpatient setting. Design: Ethnographic and interview data were collected by an interdisciplinary team over a 7 month period at four clinics. Measurements: Instances of unintended consequences were categorized using an expanded Diffusion of Innovations theory framework. Results: The framework was clarified and expanded. There are both desirable and undesirable unintended consequences, and they can be either direct or indirect, but there are also many consequences that are not clearly either desirable or undesirable or may even be both, depending on one's perspective. The undesirable consequences include error and security concerns and issues related to alerts, workflow, ergonomics, interpersonal relations, and reimplementations. Conclusion: Consequences of implementing and reimplementing clinical systems are complex. The expanded Diffusion of Innovations theory framework is a useful tool for analyzing such consequences.

Original language	English (US)
Pages (from-to)	S21-S27
Journal	International Journal of Medical Informatics
Volume	76
Issue number	SUPPL. 1
DOIs	https://doi.org/10.1016/j.ijmedinf.2006.05.017
State	Published - Jun 2007

Funding

This paper is based on one presented at the Second International Conference on Information Technology in Health Care, Portland, OR, USA, September 14, 2004. This work was funded by grant LM06942 from the U.S. National Library of Medicine, National Institutes of Health. Special thanks are extended to P. Zoe Stavri, PhD for her assistance with analysis.

Funders	Funder number
Author National Institutes of Health National Institutes of Health National Institutes of Health National Institutes of Health The Bev Hartig Huntington's Disease Foundation National Institutes of Health
U.S. National Library of Medicine	R56LM006942

Keywords

Computerized
Computerized physician order entry
Hospital information systems
Medical records systems
Online systems

ASJC Scopus subject areas

Health Informatics

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10.1016/j.ijmedinf.2006.05.017

Cite this

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title = "Categorizing the unintended sociotechnical consequences of computerized provider order entry",

abstract = "Objective: To describe the kinds of unintended consequences related to the implementation of computerized provider order entry (CPOE) in the outpatient setting. Design: Ethnographic and interview data were collected by an interdisciplinary team over a 7 month period at four clinics. Measurements: Instances of unintended consequences were categorized using an expanded Diffusion of Innovations theory framework. Results: The framework was clarified and expanded. There are both desirable and undesirable unintended consequences, and they can be either direct or indirect, but there are also many consequences that are not clearly either desirable or undesirable or may even be both, depending on one's perspective. The undesirable consequences include error and security concerns and issues related to alerts, workflow, ergonomics, interpersonal relations, and reimplementations. Conclusion: Consequences of implementing and reimplementing clinical systems are complex. The expanded Diffusion of Innovations theory framework is a useful tool for analyzing such consequences.",

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note = "Funding Information: This paper is based on one presented at the Second International Conference on Information Technology in Health Care, Portland, OR, USA, September 14, 2004. This work was funded by grant LM06942 from the U.S. National Library of Medicine, National Institutes of Health. Special thanks are extended to P. Zoe Stavri, PhD for her assistance with analysis.",

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AU - Guappone, Kenneth

AU - Carpenter, James D.

AU - Seshadri, Veena

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Categorizing the unintended sociotechnical consequences of computerized provider order entry

Abstract

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Keywords

ASJC Scopus subject areas

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