Issues Of Unintended Consequences Of Electronic Medical Records: A Proposed Study Framework

While Electronic Medical Records (EMR) or prominent features within EMR have been hailed as an important step for advancing healthcare, a number of studies have noted that its introduction also brings unintended consequences (UCs) to healthcare organizations. According to the literature, the most disruptive type of unintended consequences is related to workflow issues, in that its occurrence will impede work efficiency. Existing literature defines UCs inconsistently and identifies discrepancies in the results addressing UCs, particularly those related to workflow issues. This paper first proposes an integration and systematization of the existing literature on the unintended consequences of EMR (including its various definitions and classifications), and then constructs a framework of studying UCs associated with workflow issues using a mixture of qualitative and quantitative approaches. The main outcomes of a research based on this framework are: (1) a comprehensive understanding of workflow issues constituting the UCs pertaining to the study context, (2) a redesigned workflow addressing the workflow problems arising from the EMR implementations, and (3) suggested mitigation strategies addressing these issues The framework captures a series of phases for studying UCs relating to workflow issues. Our intended study will select a number of hospitals in a developing country as field sites and we also provide justification for our choice of the field sites.