Introduction: In recent years, there has been an increased demand to exploit the possibilities of Information Technology (IT) in health care. In many hospitals, focus is on Electronic Health care Records (EHRs) which are depicted as central technologies in supporting the examination, treatment, and care of patients. One of the modules of the EHR system is the Electronic Patient Medicine (EPM) module which is considered an important means for reducing medical errors. In the literature, focus is primarily on those medical errors that are reduced when introducing EPM modules, whereas there is scarce evidence of the new types of errors that might occur. Purpose: This paper presents an evaluation study of an EPM module implementation in an orthopaedic surgery ward and in a medical ward. The purpose of the evaluation is to investigate the nature of the errors that are reduced and the new types of errors that occur when the doctors are interacting with the EPM module. We argue that systematic evaluation attempts are necessary in order to investigate the unintended consequences that may appear when implementing IT in health care. Setting and methods: The study is explorative. It is carried out in an orthopaedic surgery ward and in a medical ward in two medium-sized Danish hospitals. Through observation studies, semi-structured interviews with health care professionals, and focus group interviews, we investigate the types of errors that may appear when implementing a new IT system such as the EPM module. We compare the findings with existing studies on this topic. Findings: The findings from our study show that earlier types of errors are reduced by the use of the EPM module. At the same time, however, the study shows that new types of errors occur. These errors can be grouped into two main categories: one type is related to the interaction between the doctor and the EPM module; the other type is related to the influence that the EPM system has on the coordination of the clinical work. Discussion and conclusions: The findings are discussed along with ways in which to reduce some of the new types of errors that appear. One of the main conclusions is that there should be more focus on evaluating IT implementations in health care. This should be done in order to pay more attention to the unintended consequences that may emerge when health care professionals are using technology in their clinical practices. On the basis of the evaluation, it is furthermore important for management to set up strategies to improve the use of IT in health care.
Evaluation; Medical errors; Health care; Patient Medicine Module; Unintended consequences
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European Conference on Information Management and Evaluation, 2007