Table 1.

Summary characteristics of included studies.

Study	Publication year	Journal	Study type	Stated aims or objectives	Date or duration of intervention	Study population or settings
Reed et al [34]	2020	American Journal of Managed Care	Observational study	To examine whether providers’ timely access to clinical information through shared inpatient-outpatient EHRsa was associated with follow-up visits, return emergency department visits, or readmissions after hospital discharge in patients with diabetes.	2005-2011	241,510 hospitalized patients with diabetes discharged home from 17 hospitals where a new inpatient EHR system is being gradually introduced which integrates with an existing outpatient EHR system.
Wong et al [35]	2020	Journal of the American Medical Directors Association	Observational study	To assess the impact of implementing a new electronic medical records transfer mechanisms or process to improve the transfer of medical records when transitioning patients between nursing facilities and acute settings	2020	HOPEb SNFc Collaborative of 25 nursing facilities working with 3 hospitals in a local health network.
Howe et al [38]	2018	JAMA	Retrospective analysis of patient safety reports	To explore how EHR usability can contribute to patient harm by reviewing patient safety reports from the Pennsylvania Patient Safety Authority database.	2013-2016	Patient safety reports from the Pennsylvania Patient Safety Authority database derived from 571 health care facilities.
Biltoft et al [40]	2018	American Journal of Health-System Pharmacy	Case study	To improve IVd infusion: medication safety accuracy, timeliness, and efficiency of IV medication documentation Free up pharmacist and nurse time for direct patient care Increase revenue by improving reimbursement for IV medications in outpatient areas	October 2013, lasting for 7 months	Regional health system consisting of 8 hospitals, excludes NICUse
D’Amore et al [36]	2018	AMIAfsymposium	Cross-sectional study	To examine testing artifacts from recent certification through automated tooling and manual review to identify compatibility and usability issues.	January 2018	854 C-CDAg documents were selected from the Office of the National Coordinator for Health Information Technology publicly available repository. After screening for duplicates, invalid XML, and documents not confirming to C-CDA 2.1 standards, 401 C-CDA documents were examined
Adams et al [39]	2017	Applied Clinical Informatics	Retrospective analysis of patient safety reports	Overall study was to understand patient safety consequences resultant from interoperability issues between EHRs and HITh. Specific objectives were: To identify patient safety incident reports that reflect EHR interoperability challenges with other health IT. To perform a detailed analysis of these reports to understand the health IT systems involved, the clinical care processes impacted, whether the incident occurred within or between provider organizations, and the reported severity of the patient safety events.	2009-2016	1.735 million PSEi reports from the Pennsylvania Patient Safety Authority’s Pennsylvania Patient Safety Reporting System, attained through the ISMPj, and a large health care system in the Mid-Atlantic United States; 209 (8%) PSE reports of the 2625 health IT reports were determined to be related to interoperability between the EHR and another health IT system.
Elysee et al [31]	2017	Medicine (United States)	Observational study	To empirically examine how the 3 capabilities (HIEk, interoperability, medication reconciliation) influence one another so the appropriate policy can be applied where it can have the greatest impact.	2013	AHAl Annual IT Survey responses; 1330 hospitals were included. 2013 AHA Annual Survey IT Supplement database to obtain a nationally representative sample of nonfederal acute care hospitals that (1) include acute care general medical and surgical, general children’s, and cancer hospitals (2) use any type of electronic exchange or sharing of care summaries with other providers
Motulsky et al [32]	2016	Studies in Health Technology and Informatics	Observational study	Evaluated the accuracy and usability of SQIM software for documenting the list of current medications for patients at admission to hospital and comparing with medication lists with pharmacies via fax.	June 2014 to January 2015	111 patients, average age of 76 years, 51% female, average of 11 medications. On the basis of tertiary care center in Montreal, Canada
Akbarov et al [37]	2015	Drug Safety	Cross-sectional study	To investigate the feasibility of linked primary and secondary care EHR data for surveillance of medication safety. Objectives included assessing the prevalence of 22 medication safety indicators, investigating associations with patient and practice characteristics, and investigating variation between general practices.	April 2012	52 general practices affiliated with 205,519 patients in Salford, United Kingdom
Munck et al [42]	2014	Danish Medical Journal	Randomized control trial+Likert scale questionnaire	Examines time expenditure and impact on workflow the use of an integrated shared medical record has on medication reconciliation at hospital admissions	June 2010	Sixty-two patient consultations, 18 physicians participated from the accident and emergency department at Køge Hospital—a university-affiliated hospital.
Koldby et al [41]	2013	Studies in Health Technology and Informatics	Simulation study	To evaluate how integration between digital dictation and EHRs impacts workflow, and functionality, and identify areas requiring further improvement.	N/Am	Three doctors (2 surgeons, one pediatrician) and 3 medical secretaries, Herlev Hospital in Copenhagen, Denmark
Lee et al [33]	2013	Studies in Health Technology and Informatics	Observational study	To develop and implement a workflow-based multidisciplinary hand-over information system, integrated with medical record browsing, multidisciplinary hand-over, and event tracking to improve the correctness and effectiveness of communication among the medical team members.	2 years, auditing was completed every 3 months	40+ seed anchors were trained on the use of the cross-disciplinary team hand-over information system. They were responsible for training nurses in their respective wards; no further detail on sample size

^aEHR: electronic health record.

^bHOPE: Health Optimization for Elders.

^cSNF: Skilled Nursing Facility.

^dIV: intravenous.

^eNICU: neonatal intensive care unit.

^fAMIA: American Medical Informatics Association.

^gC-CDA: consolidated clinical document architecture.

^hHIT: health information technology.

ⁱPSE: patient safety event.

^jISMP: Institute for Safe Medication Practices.

^kHIE: health information exchange.

^lAHA: American Hospital Association.

^mN/A: not applicable.