Table 1. Example medication safety project with and without health informatician involvement.

Project phase	Health informatician involved	No involvement of health informatician
Situation assessment	• Data obtained from health system used to assess the situation • Simulation and predictive models built to identify most prevalent unsafe medications • Interviews, surveys, and observations performed to learn patient and clinician information needs and decision-making process	• Key data missing from problem assessment • Could not prioritize or focus on specific medications • Clinical priorities emphasized, patient information needs ignored • Incorrect assumptions made about how individuals make decisions
Solution development	• Solution includes patient- and clinician-facing software changes • Solution applies rules to target most prevalent unsafe medications • Decision support solution created using user-centered design and iterative testing • Solution is interoperable	• Software not part of the solution • Targeting too many medications leads to untenable solution • Solution does not conform with usability principles, is not usable or acceptable to end-users • Solution does not work with existing software and technical infrastructure
Implementation and evaluation	• Intervention deployed and tracked in health system's EHR system • Medication data mined from EHR, compared pre–post intervention at individual and group levels • Informatician presents technical and business plans to leadership • Key organizational and political constraints successfully navigated	• Intervention cannot be deployed to all EHR system users • Data not available to perform objective pre–post evaluation • Contradictory technical and business plans written by different individuals • Failure to consider social (organizational/political) aspects results in unanticipated resistance

Abbreviation: EHR, electronic health records.