Table 6.

Prominent EHR workarounds concerning the Organization and their scope and potential impact (↑ denotes an increase, ↓ denotes a decrease, • denotes a negligible influence, and ? denotes undecided. P stands for patient, C for health care professional [clinician or clerk], and O for the overall organization).

Rationale	Workaround	Scope	Safety	Effectiveness	Efficiency
Efficiency	Not updating do not resuscitate orders as this has to be done every time a patient is readmitted to the hospital (sometimes every week)	PCO	↓	↓	↑
Data migration policy	Requesting lab results from longer than 5 years ago via an online form, as hospital management decided to not migrate lab results for more than 5 years ago to the her	PCO	↓	↓	↓
Enforced data entry	Entering patient data in progress notes rather than via the standard data entry template due to being forced to enter patient data of an unknown specificity level (eg, specific type of knee surgery a patient had 13 years ago)	PCO	↓	↓	↓
	Entering x in a mandatory data field to proceed when the supposed entry in the data field is not known or beyond one’s expertise	CO	↓	↓	↑
Required data entry option missing	Creating blank orders as multiple desired orders (eg, multivitamin supplements) are not listed in the EHR despite being available	PCO	↓	↓	↑
	Entering (a part of) a patient’s medication regimen in progress notes rather than the intended data entry fields in case the externally prescribed medication is not recognized by the EHR	PCO	↓	↓	↓
	Ordering a too low or too high drug dose enforced by technical limitations and entering a textual description in multiple data fields that the supposed dosage should be, for example, 3.75 mg per day instead of the ordered 2.5 mg per day	PCO	↓	↓	↓
	Entering a diagnosis that most closely resonates with the actual diagnosis as the desired data entry option is not offered	PCO	↓	↓	•
	Writing allergy-related patient information down in a progress note as the required allergy is not in the list of to-be-chosen allergies	PCO	↓	↓	•
	Leaving data field blank when the right option for “Reason for stopping medication” is not there in the drop-down list when stopping medication	PCO	↓	?	•