Towards safe electronic health records: A socio-technical perspective and the need for incident reporting

Health information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes it evident that health information technology has become a complex socio-technical system that is health care. Design and implementation may result in a failure; even health information technology can lead to adverse events instead of mitigating them. This paper seeks to outline the complexity of health information technology as a part of a socio-technical system, describes two failures at different organizational levels, and presents a model of how risks can occur. This research extends our knowledge on health information technology failure and potential adverse effects, which contributes to the many anecdotal accounts. The IT industry market is highly unregulated and recent reports propose some form of regulation. This paper proposes how, as a first step, proper and mandatory reporting can lead to better knowledge of failures of health information technology as part of a socio-technical system and improve deployment in the coming years.