PS1-25: Unintended Consequences of Implementing Healthcare Information Technology (HIT): A Survey of Users

Abstract

Background: Health information technologies (HIT) such as electronic medical records (EMR), computerized physician order entry (CPOE), and clinical decision support systems (CDSS) have enhanced the quality, safety, and effectiveness of medical care. There is also optimism that widespread adoption of HIT in the United States would result in significant cost savings to both providers and consumers of healthcare. However, despite the potential benefits from adopting such technologies, the adoption rates of such technologies remain low. Many observers attribute the low adoption rates to the high financial cost of the technologies, but also to unintended consequences (UC) of HIT implementation. Methods: Online survey of HIT implementers in the HMO Research Network and American Health Information Management Association members. Results: Nearly 90% of the 224 respondents were administrators or managers. The UC occurred within EMR (37.4%, N = 83), eMAR (1.4%, N = 3), other HIT system (7.2%, N = 16), or a combination of ≥ 2 systems (54.1%, N = 120). Over 60% of the systems were hospital based and 52.5% were initial implementations while 19.8% were upgrades. The majority of UC involved technical problems (46.4%) or workflow issues (39.2%). Each of the following UC occurred about 30% of the time; increased workload, poorly integrated systems, or process errors. Even after remediation efforts, the UC persisted 79.7% of the time. Conclusions: UC are common in HIT and difficult to resolve. Involve all stakeholders in HIT planning, implementation, and remediation processes.