Understanding HIT Facilitated Errors in Health IT Systems
Explore the causes and effects of errors facilitated by Health IT systems, learn how to identify potential user errors, analyze sources of mistakes, and discover solutions to prevent errors. Addressing the human factors in system design is crucial to optimizing performance and well-being.
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Working with Health IT Systems HIT Facilitated Error Cause and Effect Lecture b This material (Comp 7 Unit 6) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC00013. This material was updated by The University of Texas Health Science Center at Houston under Award Number 90WT0006. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.
HIT Facilitated Error Cause and Effect Learning Objectives Lecture b Cite examples of situations where HIT systems could increase the potential for user error Analyze sources of HIT facilitated errors and suggest realistic solutions 2
Error Vocabulary Omission Commission Slips/Lapses Mistakes Silent Cockpit CC BY-NC-ND 2.0 by WisGuard Pics Image courtesy of Dr. Patricia Abbott 3
Technology Induced or Facilitated Error Oh Schnocks! The state of healthcare technology in 2009: http://www.youtube.co m/watch?v=WxQLzdL jwp4 Mccluskey, 2010, CC-BY-NC-SA 2.0 4
Addressing the Issue Human Factors Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data, and other methods to design in order to optimize human well-being and overall system performance. (Human Factors Definition, 2000) Human Factors in Surgery Video From the Mayo Clinic http://www.youtube.com/watch?v=xR78dXTYy9c 5
Finishing Out Helping to Avoid Error In HIT Computer screens/layouts/systems that are: Easy to read Easy to understand Logical Support cognition not thwart Agile & flexible Help to prevent error Make the right thing the easiest thing 6
Unit 6: HIT Facilitated Error Cause and Effect Summary Lecture b Knowledge of how HIT can prevent errors is just as important as understanding how it facilitates error As HIT professionals help users make the best decisions 7
HIT Facilitated Error Cause and Effect References Lecture b References AHRQ Web M&M: Glossary. Available from: http://www.webmm.ahrq.gov/popup_glossary.aspx?name=mistakes Joan S. Ash, R. (2007). Some Unintended Consequences of Clinical Decision Support Systems. AMIA Annual Symposium Proceedings, 2007, 26. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813668/ Timothy A.D. Graham, B. (2008). How Usability of a Web-Based Clinical Decision Support System Has the Potential to Contribute to Adverse Medical Events. AMIA Annual Symposium Proceedings,2008, 257. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2655970/ Human Factors Definition (2000). Available from: http://www.hfes.org/Web/EducationalResources/HFEdefinitionsmain.html Joint Commission. c2011. Available from: http://www.jointcommission.org/sentinelevents/se_glossary.htm HealthcareHF,. (2009). Oh Shnocks! The state of healthcare technology in '09. Retrieved from https://www.youtube.com/watch?v=WxQLzdLjwp4 Mayo Clinic,. (2008). Human Factors in Surgery-Mayo Clinic. Retrieved from https://www.youtube.com/watch?v=xR78dXTYy9c 8
HIT Facilitated Error Cause and Effect References Lecture b Images Slide 2: Image 1: Corpsman Giving Shot to Female Patient. Available from: http://farm5.static.flickr.com/4125/5094485790_dde2e1b735.jpg Image 2: " !!STOP!! Do Not Disturb! Passing Medications. Created by Dr. Patricia Abbott. Slide 4: Mccluskey, A. (2010). Frustration. [Online Image].Retrieved June 14, 2016 from http://www.flickr.com/photos/14511253@N04/4411497087/sizes/m/in/photostream/ 9
Working with Health IT Systems HIT Facilitated Error Cause and Effect Lecture b This material was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC00013. This material was updated by The University of Texas Health Science Center at Houston under Award Number 90WT0006. 10
