Table 1.
Papers reviewed (ordered chronologically based on year of publication)
| Study | Country | Setting | Organization type | Main intervention | Study design | Main method | Source of data |
|---|---|---|---|---|---|---|---|
| Campos-Castillo C, Anthony DL The double-edged sword of electronic health records: implications for patient disclosure. J Am Med Inform Assoc 2015;22(e1):e130–40. | U.S. | n/a | n/a | EHR | Quantitative | Cross sectional | Questionnaire survey |
| Cresswell KM, Bates DW, Williams R, Morrison Z, Slee A, Coleman J, Robertson A, Sheikh A. Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two ‘early adopter’ hospitals. J Am Med Inform Assoc 2014;21(e2):e194–202. | U.K. | Hospital-wide | One teaching hospital; one non-teaching hospital | CPOE and clinical decision support | Qualitative | Case study (implemented for at least 2 years) | Artifacts; Interviews; Observations |
| Fleming NS, Becker ER, Culler SD, Cheng D, McCorkle R, da Graca B, Ballard DJ. The impact of electronic health records on workflow and financial measures in primary care practices. Health Serv Res 2014;49(1 Pt 2):405–20. | U.S. | Ambulatory care | Primary care practices affiliated with healthcare system | EHR | Quantitative | Interrupted time series (evaluated 1-6, 7-12, and >12 months post-implementation) | Administrative, payroll, and billing data |
| Howley MJ, Chou EY, Hansen N, Dalrymple PW. The long-term financial impact of electronic health record implementation. J Am Med Inform Assoc 2015;22(2):443–52. | U.S. | Ambulatory care | Academic medical center/Teaching hospital | EHR | Quantitative | Pre-post (repeated measures 1 year before and 2 years after) | Billing data |
| Hysong SJ, Spitzmuller C, Espadas D, Sittig DF, Singh H. Electronic alerts and clinician turnover: the influence of user acceptance. Am J Manag Care 2014;20(11 Spec No. 17):SP520–30. | U.S. | Ambulatory care | Primary care practices of U.S. Department of Veterans Affairs | Electronic alerts | Quantitative | Cross sectional | Questionnaire survey |
| Meeks DW, Smith MW, Taylor L, Sittig DF, Scott JM, Singh H. An analysis of electronic health record-related patient safety concerns. J Am Med Inform Assoc 2014;21(6):1053–9. | U.S. | n/a | U.S. Department of Veterans Affairs | EHR | Qualitative | Retrospective (3.5 years of incident reports) | Incident reports |
| Melby L, Hellesø R. Introducing electronic messaging in Norwegian healthcare: unintended consequences for interprofessional collaboration. Int J Med Inform 2014;83(5):343–53. | Norway | Homecare and ambulatory care | Public healthcare system | Electronic messaging | Qualitative | Implemented 2008-2009, interviews in 2011 | Interviews |
| Nanji KC, Rothschild JM, Boehne JJ, Keohane CA, Ash JS, Poon EG. Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. J Am Med Inform Assoc 2014;21(3):481–6. | U.S. | Pharmacy | Pharmacy | Electronic prescribing | Qualitative | Implemented in 2008; study conducted over 10 weeks in 2010 | Observations; Interviews |
| Pell JM, Cheung D, Jones MA, Cumbler E. Don’tfuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. J Am Med Inform Assoc 2014;21(6):1109–12. | U.S. | Inpatient | Academic medical center/Teaching hospital | Electronic alerts | Quantitative | Retrospective cohort (8 months before, 8 months after) | Chart abstraction |
| Redd TK, Read-Brown S, Choi D, Yackel TR, Tu DC, Chiang MF. Electronic health record impact on productivity and efficiency in an academic pediatric ophthalmology practice. J AAPOS 2014;18(6):584–9. | U.S. | Pediatric ophthalmology | Academic medical center/Teaching hospital | EHR | Quantitative | Pre-post (3 months before, 3 years after) | Practice management system (pre) and EHR enterprise reporting system (post) |
| Risko N, Anderson D, Golden B, Wasil E, Barrueto F, Pimentel L, Hirshon JM. The impact of electronic health record implementation on emergency physician efficiency and patient throughput. Healthc(Amst)2014;2(3):201–4. | U.S. | ED | Community hospital | EHR | Quantitative | Prospective pre-post (7 months before, 10 months after) | Timestamps from the core data system |
| Saddik B, Al-Mansour S. Does CPOE support nurse-physician communication in the medication order process? A nursing perspective. Stud Health Technol Inform 2014;204:149–55. | Saudi Arabia | Hospital-wide | Public healthcare system | CPOE | Quantitative | Cross sectional | Questionnaire survey |
| Sanders DS, Read-Brown S, Tu DC, Lambert WE, Choi D, Almario BM, Yackel TR, Brown AS, Chiang MF. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing. JAMA Ophthalmol 2014;132(5):586–92. | U.S. | Operation Room | Academic medical center/Teaching hospital | EHR and Operation Room Management System | Quantitative | Prospective cohort pre-post (3 weeks before, 12 months after); Case series | Time and motion observations; Enterprise data warehouse |
| Ser G, Robertson A, Sheikh A. A qualitative exploration of workarounds related to the implementation of national electronic health records in early adopter mental health hospitals. PLoS One 2014(1):e77669. | U.K. | Mental health hospitals | Public healthcare system | EHR | Qualitative | Longitudinal (data collected over a 1.5 year period) | Interviews |
| Ward MJ, Froehle CM, Hart KW, Collins SP, Lindsell CJ. Transient and sustained changes in operational performance, patient evaluation, and medication administration during electronic health record implementation in the emergency department. Ann Emerg Med 2014;63(3):320–8. | U.S. | ED | Academic medical center/Teaching hospital | EHR | Quantitative | Longitudinal (for 6 months post-implementation) | Administrative electronic tracking systems (pre) and EHR (post) |
| Woolhandler S, Himmelstein DU. Administrative work consumes one-sixth of U.S. physicians’ working hours and lowers their career satisfaction. IntJ Health Serv 2014;44(4):635–42. | U.S. | n/a | n/a | EHR | Quantitative | Cross sectional | Questionnaire survey |
| Benda NC, Meadors ML, Zachary Hettinger A, Ratwani RM. Emergency physician task switching increases with the introduction of a commercial electronic health record. Ann Emerg Med 2015. pii: S0196-0644(15)01104-X. [Epub ahead of print] | U.S. | ED | Academic medical center/Teaching hospital | EHR; from homegrown system to commercial system | Quantitative | Pre-post (1 month before, 1 week after, and 3-4 months after) | Field observations |
| Carayon P, Wetterneck TB, Alyousef B, Brown RL, Cartmill RS, McGuire K, Hoonakker PL, Slagle J, Van Roy KS, Walker JM, Weinger MB, Xie A, Wood KE. Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit. Int J Med Inform 2015;84(8):578–94. | U.S. | ICU | Academic medical center/Teaching hospital | EHR | Quantitative | Prospective pre-post (3 months after) | Field observations |
| Carrington JM, Gephart SM, Verran JA, Finley BA. Development of an instrument to measure the unintended consequences of EHRs. West J Nurs Res 2015;37(7):842–58. | U.S. | n/a | Unknown | EHR | Qualitative | n/a | Interviews |
| Cifuentes M, Davis M, Fernald D, Gunn R, Dickinson P, Cohen DJ. Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care. J Am Board Fom Med 2015;28 Suppl 1:S63–72. | U.S. | Ambulatory care | Primary care practice of varied ownership | EHR | Qualitative | Cross-case comparative study | Field observations; Online diaries; Interviews; Artifacts; Questionnaire survey |
| Crowson MG, Vail C, Eapen RJ. Influence of electronic medical record implementation on provider retirement at a major academic medical centre. J Eval Clin Pract 2015. [Epub ahead of print] | U.S. | n/a | Academic medical center/Teaching hospital | EHR | Quantitative | Retrospective pre-post (12 months after) | Human resources records |
| Georgiou A, Prgomet M, Lymer S, Hordern A, Ridley L, Westbrook J. The Impact of a Health IT changeover on medical imaging department work processes and turnaround times: a mixed method study. Appl Clin Inform.2015;6(3):443–53. | Australia | ED | Academic medical center/Teaching hospital | Picture archiving and communication system and radiology information system | Mixed methods | Retrospective pre-post (4-5 months before and 1 year after) | Interviews; Charts |
| Graber ML, Siegal D, Riah H, Johnston D, Kenyon K. Electronic health record-related events in medical malpractice claims. J Patient Saf 2015. [Epub ahead of print] | U.S. | n/a | n/a | EHR | Mixed methods | Retrospective cohort study | Malpractice suits and claims database |
| Lafata JE, Shay LA, Brown R, Street RL. Office-based tools and primary care visit communication, length, and preventive service delivery. Health Serv Res 2015. [Epub ahead of print] | U.S. | Ambulatory care | Primary care practices affiliated with healthcare system | EHR in addition toother office-based tools | Quantitative | n/a | Questionnaire survey; Field observations; Office visit audio-recordings; Charts |
| Magrabi F, Baker M, Sinha I, Ong MS, Harrison S, Kidd MR, Ranchman WB, Coiera E. Clinical safety of England’s national program for IT: a retrospective analysis of all reported safety events 2005 to 2011. Int J Med Inform 2015;84(3):198–206. | U.K. | n/a | Public healthcare system | Any IT | Quantitative | Retrospective analysis (6 years of incident reports) | Event database |
| McLean TA, Lewkowitz AK, Test E, Zlatnik MG. Does an electronic health record improve completeness of prenatal studies? Appl Clin Inform 2015;6(4):669–76. | U.S. | Ambulatory care (prenatal) | Academic medical center/Teaching hospital | EHR | Quantitative | Retrospective cohort (1 year before and 2 years after) | Charts |
| Overhage JM, Gandhi TK, Hope C, Seger AC, Murray MD, Orav EJ, Bates DW. Ambulatory computerized prescribing and preventable adverse drug events. J Patient Saf 2015. [Epub ahead of print] | U.S. | Ambulatory care | Primary care practices affiliated with academic medical center | CPOE | Quantitative | Pre-Post (each period lasting 6 months) | Charts |
| Rizzato Lede DA, Benítez SE, Mayan JC 3rd, Smith MI, Baum AJ, Luna DR, Bernaldo de Quirós FG. Patient safety at transitions of care: use of a compulsory electronic reconciliation tool in an academic hospital. Stud Health Technol Inform 2015;216:232–6. | Argentina | Inpatient | Academic medical center/Teaching hospital | Electronic reconciliation | Quantitative | Cross sectional (9-month after) | Charts |
| Russell RA, Triscari D, Murkowski K, Scanlon MC. Impact of computerized order entry to pharmacy interface on order-infusion pump discrepancies. J Drug Deliv 2015;2015:686598. | U.S. | PICU | Academic medical center/Teaching hospital | CPOE | Quantitative | Prospective pre-post | Field observations |
| Tall JM, Hurd M, Gifford T. Minimal impact of an electronic medical records system. Am J Emerg Med 2015;33(5):663–6. | U.S. | ED | Academic medical center/Teaching hospital | EHR | Quantitative | Retrospective before, during, and after (each period lasting 5.5-6 months) | Charts |
| Thirukumaran CP, Dolan JG, Reagan Webster P, Panzer RJ, Friedman B. The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures. Health Serv Res 2015;50(1):273–89. | U.S. | Inpatient | Academic medical center/Teaching hospital | EHR | Quantitative | Pre-post (3 months post) | Charts |
| Varpio L, Day K, Elliot-Miller P, King JW, Kuziemsky C, Parush A, Roffey T, Rashotte J. The impact of adopting EHRs: how losing connectivity affects clinical reasoning. Med Educ 2015;49(5):476–86. | Canada | PICU and inpatient | Academic medical center/Teaching hospital | EHR | Qualitative | Longitudinal before, during, and after (for 11 months before, for 18 months during and after) | Field observations; Think-aloud sessions; Think-after sessions; Interviews; Artifacts |
| Victores AJ, Coggins K, Takashima M. Electronic health records and resident workflow: a time-motion study of otolaryngology residents. Laryngoscope 2015;125(3):594–8. | U.S. | Otolaryngology operation room and clinic | Academic medical center/Teaching hospital | EHR | Quantitative | Prospective pre-post (1 year after) | Time and motion observations |
| MacMillan TE, Slessarev M, Etchells E. eWasted time: Redundant work during hospital admission and discharge. Health Informatics J 2016;22(1):60–6. | Canada | Inpatient | Academic medical center/Teaching hospital | EHR | Quantitative | n/a | Time and motion observations; Questionnaire survey |