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. "Appendix C: Observations, Consequences, and Opportunities: The Site Visits of the Committee." Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. Washington, DC: The National Academies Press, 2009.
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Observations—What Committee Members Saw
Consequences—Why the Observations Matter
Opportunities for Action—What We Can Do About Ita
Category 6. Change in a Sociotechnical System
Most systems are partially or poorly or incompletely integrated into practice
Inconsistent use and work-arounds increase error
Benefits are significantly less than anticipated
Focus on the desired outcomes instead of the technology (S/R)
Innovation requires locally adaptable systems but interoperability and evidence-based medicine require more standardization
Limited innovation and standardization
Management that encourages initiation of improvements by health professionals (S)
Technology and processes that allow local innovation and flexibility but foster collaboration and learning at a national scale (R)
aR, solutions still to be discovered (research); S, solutions known today but not implemented (short term).