Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics

Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics

Improvement in quality and safety in health care often depends on eliminating errors. Using examples from our research on the medical testing processes in primary care medical practices, we argue that designing safer systems requires moving beyond frameworks that focus exclusively on error eliminati...

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Main Authors: Timothy R. McEwen, Nancy C. Elder, John M. Flach
Format: Article
Language:English
Published: Hindawi Limited 2011-01-01
Series:Journal of Healthcare Engineering
Online Access:http://dx.doi.org/10.1260/2040-2295.2.1.87
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spelling doaj-cee88e17b53046b090e42818ef369d582020-11-24T23:12:56ZengHindawi LimitedJournal of Healthcare Engineering2040-22952011-01-0121879610.1260/2040-2295.2.1.87Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System DynamicsTimothy R. McEwen0Nancy C. Elder1John M. Flach2Department of Psychology, Wright State University, 335 Fawcett Hall, Dayton, Ohio, 45324, USADepartment of Family and Community Medicine, University of Cincinnati, PO Box 670582, Cincinnati, Ohio, 45267, USADepartment of Psychology, Wright State University, 335 Fawcett Hall, Dayton, Ohio, 45324, USAImprovement in quality and safety in health care often depends on eliminating errors. Using examples from our research on the medical testing processes in primary care medical practices, we argue that designing safer systems requires moving beyond frameworks that focus exclusively on error elimination to consider the broader system dynamics including information loops that can be critical to the overall stability of the system. We focus on describing the nature of information coupling in relation to the constructs of essential friction, autonomation, and ecological interface design and how these can lead to more resilient systems. With the recent push in the United States to move towards electronic medical records (EMR), we conclude with suggestions for improving EMR systems based on these concepts.http://dx.doi.org/10.1260/2040-2295.2.1.87
collection DOAJ
language English
format Article
sources DOAJ
author Timothy R. McEwen
Nancy C. Elder
John M. Flach
spellingShingle Timothy R. McEwen
Nancy C. Elder
John M. Flach
Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
Journal of Healthcare Engineering
author_facet Timothy R. McEwen
Nancy C. Elder
John M. Flach
author_sort Timothy R. McEwen
title Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
title_short Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
title_full Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
title_fullStr Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
title_full_unstemmed Creating Safety in Primary Care Practice with Electronic Medical Records Requires the Consideration of System Dynamics
title_sort creating safety in primary care practice with electronic medical records requires the consideration of system dynamics
publisher Hindawi Limited
series Journal of Healthcare Engineering
issn 2040-2295
publishDate 2011-01-01
description Improvement in quality and safety in health care often depends on eliminating errors. Using examples from our research on the medical testing processes in primary care medical practices, we argue that designing safer systems requires moving beyond frameworks that focus exclusively on error elimination to consider the broader system dynamics including information loops that can be critical to the overall stability of the system. We focus on describing the nature of information coupling in relation to the constructs of essential friction, autonomation, and ecological interface design and how these can lead to more resilient systems. With the recent push in the United States to move towards electronic medical records (EMR), we conclude with suggestions for improving EMR systems based on these concepts.
url http://dx.doi.org/10.1260/2040-2295.2.1.87
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AT nancycelder creatingsafetyinprimarycarepracticewithelectronicmedicalrecordsrequirestheconsiderationofsystemdynamics
AT johnmflach creatingsafetyinprimarycarepracticewithelectronicmedicalrecordsrequirestheconsiderationofsystemdynamics
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