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Unintended Consequences: New Problems, New Solutions. Contributions From 2015.

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The best 2015 research on healthcare information technology (HIT) unintended consequences shows growing awareness and creative methods for identification. However, complex causes limit universally applicable recommendations for avoiding adverse outcomes.

Keywords:
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Area of Science:

  • Health Informatics
  • Information Science
  • Medical Informatics

Background:

  • Healthcare Information Technology (HIT) implementation can lead to unintended consequences.
  • Identifying and mitigating these adverse outcomes is crucial for effective healthcare delivery.
  • Previous research has explored various facets of HIT's impact on clinical practice.

Purpose of the Study:

  • To identify and select the most impactful research published in 2015 concerning the unintended consequences of HIT.
  • To synthesize findings from high-quality empirical studies on HIT's unforeseen effects.
  • To provide a curated list of exemplary research for future study and practice.

Main Methods:

  • Comprehensive literature searches across multiple disciplines including IT, human factors, and implementation science.
  • Development of a nuanced search algorithm to capture studies not explicitly using "unintended consequences" in titles or abstracts.
  • Rigorous filtering based on original empirical investigation and non-negligible impact (statistical significance or prominent qualitative themes).
  • Multi-stage review process involving four independent reviewers for 15 candidate papers, culminating in a final selection of four best papers.

Main Results:

  • An initial pool of 754 papers was screened down to 171, then to 33 empirical studies meeting inclusion criteria.
  • Fifteen papers were identified as best paper candidates, undergoing detailed evaluation by four reviewers.
  • A final selection of four outstanding papers on HIT's unintended consequences was made.

Conclusions:

  • There is increasing recognition of the significance of unintended consequences stemming from HIT, its vendors, implementation, and users.
  • Research demonstrates greater creativity in data sources (e.g., malpractice cases, surveys) and acceptance of mixed methods.
  • The complexity of causes complicates the development of universally applicable recommendations, with lessons learned often being general.