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Chapter 6

HSS 3332 Chapter Notes - Chapter 6: Health Informatics, Unintended Consequences

Health Sciences
Course Code
HSS 3332
Sarah Fraser

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Health Informatics
Ash et al (2004): Unintended consequences of information technology in health care
Describe two major kinds of silent errors caused by health care information systems and
give examples of each kind.
Those related to entering and retrieving information
o 1) PCIS that have human-computer interfaces that are not suitable for this highly
interruptive use context
Too many options, clicking the wrong one; juxtaposition errors; the kind
of error that can result when something is close to something else on the
screen and the wrong option is too easily clicked in error
o 2) PCISs that cause cognitive overload by over-emphasizing structured and
complete information entry or retrieval
Structure overly structured data entry led to a loss of cognitive focus by
the clinician
Loss of overview from having to use so many screens to enter
many details
Switching between so many screens worked against their ability to
acquire, maintain, and refine a mental overview of the case
The action of clicking through so many screens inevitably
fragmented the cognitive ‘images’ they were constructing
Limit easy access to other people’s notes hampering the ability to
be optimally informed
Over completeness
Reporting systems can mistake completeness for efficacy; the
systems that produced complete” reports reduced the usability and
the transparency of these reports or discharge letters
If you have too much standard text it becomes easy to push the
button and add some more
Decreased the readability and information value of the reports
Is the sentence part of the template or a result of a thoughtful
weighing of words, threatens to obscure the transparency that such
systems attempt to introduce
Ease of use can lure users into learning new but poor recording
Those related to communication and coordination
o 1) Misrepresenting collective, interactive work as a linear, clear cut, and
predictable workflow
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