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Health Systems Institute
Georgia Institute of Technology
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Seed Grant Profile


2013-2014 Program

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Dealing with the Side-effects of Automation: Threats to Workflow and Safety Introduced by Health Information Technology

While the implementation of electronic health records (EHRs) holds the promise of improving patient safety and the quality of healthcare, this is often not realized in the clinical setting. EHRs also may introduce new hazards into the workplace. Some of the consequences of EHR implementation include increased work for clinicians, changes to established workflows, and changes in communication patterns. These and other unintended consequences lead to new types of medical errors. We will study the effects of the EHR on clinician ideal workflows and patient safety through novel techniques. Specific Aims Aim 1: Identify the ideal patient care workflow from the perspective of clinicians and characterize threats to this ideal clinician workflow that are introduced by the electronic health record. We will perform structured interviews using a modified Wizard of Oz appraoch with talk-throughs of simulated patient encounters to determine identify the ideal workflow based on cognitive work of physicians. We will characterize these deviations from the ideal workflow introduced by the EHR to determine those placing highest risk for patient safety and job dissatisfaction. Aim 2: Identify and characterize threats to patient safety introduced by the electronic health record. We will perform structured interviews called threat-strategy-interviews to characterize threats to patient safety introduced by EHRs. We will determine how these threats can be identified and avoided. By identifying these threats and the responses to these risks, we will be able to develop interventions in order to help avoid these threats to workflow and avoid dangerous responses to these threats.

Investigators: Marla Daves (Aflac Children's Cancer Center and Emory University/Children's Healthcare of Atlanta), Frank Durso (Georgia Tech),

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