Creating safety in primary care practice with electronic medical records requires the consideration of system dynamics

Timothy R. McEwen, Nancy C. Elder, John M. Flach

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)87-96
Number of pages10
JournalJournal of Healthcare Engineering
Volume2
Issue number1
DOIs
StatePublished - Mar 2011
Externally publishedYes

Keywords

  • Autonomation
  • Ecological interface design
  • Electronic medical records
  • Essential friction
  • Healthcare quality
  • Safety

ASJC Scopus subject areas

  • Biotechnology
  • Surgery
  • Biomedical Engineering
  • Health Informatics

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