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FIN-TIERA: A Tool for Assessing Technology Induced Errors.

Sari Palojoki1, Tuuli Pajunen, Lasse Lehtonen

  • 1Sari Palojoki, Helsinki and Uusimaa Hospital District and Helsinki University Hospital, Group Administration, P.O. Box 100, 00029 Helsinki, Finland,

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Summary

A new questionnaire, FIN-TIERA, assesses Electronic Health Records (EHR) user safety concerns. This tool demonstrates initial reliability and validity for hospital settings, aiding proactive risk management.

Keywords:
Electronic health recordspatient safetypsychometricsquestionnairesocio-technical research

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Area of Science:

  • Health Informatics
  • Patient Safety
  • Socio-technical Systems

Background:

  • Health Information Systems (HIS) complexity can lead to technology-induced errors, impacting patient care.
  • Electronic Health Records (EHR) errors pose risks to patient safety.
  • Tools for proactively identifying EHR safety issues are underdeveloped.

Purpose of the Study:

  • To design a Finnish questionnaire for measuring EHR users' perceptions of safety concerns.
  • To evaluate the questionnaire's reliability and validity (content and construct) using socio-technical dimensions.
  • To adapt and validate an instrument for assessing EHR-related safety in a specialized hospital district.

Main Methods:

  • Developed the FIN-TIERA questionnaire based on socio-technical theory and expert evaluation for content validity.
  • Utilized a cross-sectional design with 2864 clinicians to test psychometric properties.
  • Assessed internal consistency, construct validity (confirmatory factor analysis), and discriminant validity.

Main Results:

  • All eight multi-item scales demonstrated high internal consistency (Cronbach's alpha > 0.798).
  • Confirmatory factor analysis indicated acceptable model fit, supporting convergent validity (AVE > 0.5).
  • Discriminant validity was established for five of eight latent variables.

Conclusions:

  • The FIN-TIERA questionnaire is a novel, multi-dimensional instrument for assessing EHR risks.
  • Initial testing confirms its reliability and validity for in-hospital use.
  • Further research is recommended to fully assess the instrument's psychometric properties.