JMIR Publications

ABSTRACT

Background:

The widespread use of Information technology (IT) has contributed to improved patient safety in the hospital setting. However, many different kinds of medical errors that are attributable to the use of IT in healthcare negatively impact patient safety. The continued occurrence of a large number of errors is a reminder that Health Information Technology (HIT)software testing and validation do not seem adequate in terms of ensuring the functioning of the software within the healthcare organization.

Objective:

This study aims to classify technology-related medical errors in a hospital setting using an expanded version of the socio-technical framework to understand the significant differences in the perceptions of clinical and technology stakeholders about the potential causes of these errors. The paper also provides some recommendations to avoid these errors in the future.

Methods:

Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to identify articles containing technology-related errors, we retained 36 articles from which we identify 48 unique patient safety events. Twelve specific issues strictly related to the hospital setting were then shortlisted. Subsequently, we conduct multiple semi-structured interviews with medical and Information Technology (IT) professionals separately to map the events on the different dimensions of the expanded socio-technical framework which includes the subcomponents of the four pillars of the socio-technical framework (people, technology, process, and environment). The perspectives on the underlying causes offered by these experts help us understand the significant ‘gulf’ that exists between IT and medical professionals.

Results:

Mapping errors based on this classification provides more critical insights about the errors, their potential root causes, and possible solutions while taking into account their repercussion on the other pillars of the socio-technical framework. This study highlights significant differences in medical/clinical staff members' and IT professionals' perceptions regarding technology-related medical errors and offer some prescriptions to address the errors.

Conclusions:

Knowledge of the dimensions of the socio-technical framework and their interplay with other dimensions can guide the choice of ways to address these errors. Findings lead us to conclude that designers need to possess not only a high degree of health information technology know-how but also a strong understanding of the medical processes and contextual factors. Although software development teams have historically included clinicians as business analysts or subject matter experts to bridge the gap, development teams will be better served by more immersive exposure to clinical environments, which may lead to better software design and implementation strategies, and ultimately to enhanced patient safety.