Table 2.

Synthesis of evidence for impact of implementation of EHR on predefined patient safety areas¹⁴

Patient safety area	Evidence for impact	Limitations
Adverse drug events	Evidence identified	Evidence for effects on documentation of allergies, drug interactions (process measures) and rate and reporting of adverse events (outcomes measures). Additional evidence from literature on specialist systems.
Infection	Limited evidence identified	Changes to antibiotic prescribing (process measure) and catheter related infections (outcome measure).
Delirium	None identified
Adverse event after hospital discharge or clinical handover	Limited evidence identified	The review was limited to effects in hospital. There was limited evidence for impact on clinical handover with reduction of ‘non-routine-events’ (outcome measure).
Falls	Limited evidence identified	No change in falls rates (outcome measure).
Adverse event in surgery	None identified
Cardiopulmonary arrests	Limited evidence identified	Evidence for reduced rate of cardiopulmonary arrests (outcome measure) from literature on specialist systems only.
Venous thromboembolism	Limited evidence identified	Changes in prescribing of prophylactic interventions (process measure).
Staffing	None identified
Pressure ulcer	Limited evidence identified	Improved documentation (process measure).
Mechanical complication and underfeeding	None identified
Clinical pathway	Limited evidence identified	Improved readability (process measure).
Safety culture	None identified
External inspection	None identified

EHR, electronic health record.