Sustainable Information Infrastructures: Insights from a Realist Synthesis.

Area of Science:

• Health Informatics
• Patient Safety Research
• Health Services Management

Background:

• Interoperable health information technology systems are increasingly advocated by policymakers and health system managers.
• The clinical effectiveness and return on investment for these systems remain largely unproven.
• Patient safety is a critical outcome influenced by health information technology.

Purpose of the Study:

• To present early findings from a systematic review on the effects of interoperable systems on patient safety.
• To explore the evidence linking interventions, decisions, actions, and outcomes in the context of interoperable health IT.
• To identify gaps in the evidence base and suggest areas for future research.

Main Methods:

• Systematic review employing realist synthesis methodology.
• Focus on understanding the mechanisms and context that link interoperable systems to patient safety outcomes.
• Analysis of evidence concerning decisions and actions within socio-technical healthcare environments.

Main Results:

• The current evidence base provides plausible arguments for investing in interoperable health information technology.
• Limited empirical data exists for specific steps in the causal pathways linking these systems to patient safety.
• The review highlights the need for sustainable socio-technical solutions.

Conclusions:

• While arguments for investment exist, robust empirical evidence on the impact of interoperable systems on patient safety is limited.
• Informatics field methods are crucial for understanding the role of these systems in enhancing patient safety.
• Further research is needed to design effective and sustainable socio-technical implementations.