Interdependent activities for building a safer system for health IT.

settings. The use of health IT is intended to aid in performing technical work that is also cognitive work, such as coordinating resources for a procedure, assembling patient data for action, or supporting a decision that requires knowledge of resource availability. However, creating a graphical representation of the information needed to support the complex processes clinicians use to collect and analyze data elements, consider alternative choices, and then make a definitive decision is challenging.

The introduction of health IT sometimes changes clinical workflows in unanticipated ways; these changes may be detrimental to patient safety. Although some templates may be very useful to providers, a rigid template for recording the “history of present illness,” for example, may alter the conversation between physician and patient in such a way that important historical clues are not conveyed or received. An inflexible order sequence may require the provider to hold important orders in mind while navigating through mandatory screens, increasing the cognitive workload of communicating

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