Health information technology (HIT) has changed the way clinicians work, and brought some advantages and disadvantages to clinical practice. In this special focus issue of JAMIA, our guest associate editors (p. 244) introduce three articles on the effects of HIT for patient safety (p. 246, p. 261, p. 268). Additional articles report on algorithms to measure patient safety (p. 310), and an interactive tool for cross-over analyses of EHRs for patient safety (p. 323).
Prescription of medications is an area in which the effects of HIT for patient safety are well studied. Articles reporting on the analyses of medication errors (p. 316), computerized prescriber order entry (CPOE) system-related patient safety reports (p. 316), variation in high priority drug-drug interaction alerts across institutions (p. 331), clinician response to electronic health record (EHR) prompts (p. 275), and alert override analysis (p. 409) are directly connected to topics in this special focus issue. This issue also includes articles on a tool for automated screening for medication errors (p. 281), an approach for automated identification of antibiotic overdoses and adverse events (p. 295), and the impact of CPOE on the length of stay and mortality rate in an academic medical center (p. 303), and an intensive care unit (p. 413). Completing the set of articles focused on HIT and patient safety are two systematic reviews—one on automation bias (p. 423) and another on types and causes of prescribing errors generated from CPOE systems (p. 432), a brief communication on changes in the quality of care due to Meaningful Use implementation (p. 394), approaches to leverage EHRs for failure mode and effects analysis on a cardiology unit (p. 288), and approaches to leverage EHRs to identify complex atrial fibrillation patients for targeted intervention (p. 339).
This issue also covers broad informatics topics that indirectly affect patient safety—the reuse of clinical and population health data to gain new insights into health outcomes. Clinical decision support systems rely on evidence generated from large amounts of data, hence data sharing is a pre-requisite for the successful development of such systems. We present an experience of opening government data to the public (p. 345), a study on patient preferences towards clinical data sharing (p. 380), a case report on improving the discoverability of ‘omics data sets (p. 388), and a predictive model for heart failure (p. 361). Interfacing applications to EHR systems (p. 398) and providing decision support in acute care (p. 441) are also presented, including the use of social media for translating evidence into practice (p. 403). A systematic review of context-sensitive decision support (p. 460) helps readers understand the general value of clinical decision support systems.
Finally, HIT influence in healthcare is dependent on patient and provider engagement. Online cancer communities for social support (p. 451) and maternal and newborn mHealth interventions (p. 352) are reported in this issue of JAMIA. The mHealth interventions are deployed in Guatemala, reminding us that generalizable informatics ideas from all over the world need to be disseminated in JAMIA. Related to the globalization of informatics and HIT is the article on lessons learned and benchmarks for HIT in 30 countries (p. 371).
Direct and indirect informatics interventions are changing the way we study health and disease, and provide healthcare. JAMIA is proud to feature the full spectrum of topics and serve as the dissemination vehicle for our professional specialty worldwide.