Reasons (not) to Spend a Few Billions More on EHRs: How Human Factors Research Can Help

Area of Science:

• Medical Informatics
• Human Factors Engineering
• Organizational Behavior

Background:

• Electronic Health Records (EHRs) are central to modern healthcare, yet adoption and effective use face challenges.
• Understanding the human and organizational aspects of EHR implementation is critical for success.

Purpose of the Study:

• To identify and select the top research papers from 2013 focusing on human factors and organizational issues (HFOI) in EHR adoption, design, and impact.
• To highlight how HFOI perspectives can improve EHR systems and their integration into clinical practice.

Main Methods:

• A comprehensive literature search of PubMed and manual searches identified 2,764 relevant papers.
• Papers were screened using inclusion/exclusion criteria, with 15 candidates selected for review.
• Four external reviewers evaluated the candidate papers using a standardized grid to determine the best research works.

Main Results:

• Five key papers were selected, demonstrating the value of HFOI in EHR adoption and design.
• Selected studies utilized social and cognitive science methodologies to analyze clinician attitudes, EHR use, and impact on care processes.
• The research emphasized the importance of macro- and meso-level factors in EHR adoption and highlighted the need for qualitative studies on EHR side effects.

Conclusions:

• HFOI approaches are essential for aligning EHR systems with end-user needs.
• Implementing HFOI methodologies can significantly reduce EHR adoption failures and mitigate unexpected negative consequences.
• Bridging the gap between technology and users through HFOI is key to optimizing EHR impact in healthcare.