Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Sociotechnical Aspects: Clinicians and Technology
Lecture:Sociotechnical aspects of health care
Slide content:Unintended Consequences of Technological Change Changes in workflow may not improve overall system efficiency Clinicians may be unable to adapt to the change Outcome measures may not be positive The implementation is just as important as the technology or the system 16
Slide notes:The implementation of technology and the process of technological change may have unintended consequences. Changes in workflow may be a step backwards for overall system efficiency. Furthermore, clinicians may be unable to adapt to the change that is occurring around them. For example, in 2002, Cedars-Sinai Hospital in California implemented an EHR system. This led to a revolt by physicians, and Cedars-Sinai had to abandon the implementation after three months. Another potential issue associated with the implementation of complex technology is that outcome measures may not be positive. For example, Childrens Hospital in Pittsburgh implemented computerized physician order entry, or CPOE, in its intensive care unit and subsequently reported an alarming increase in mortality rates. The actual process for implementing new technology is just as important as the technology itself or the system where its used. The findings at Childrens Hospital in Pittsburgh could not be replicated when other pediatric hospitals implemented the same EHR system. This suggests that the Pittsburgh implementation was flawed, with devastating unintended consequences. 16