The Precarious Gap between Information Technology and Patient Safety: Lessons from Medication Systems

This chapter explores the effect of Health Information Technology (HIT) on patient safety and tries to illuminate important mechanisms through which these systems may function in a counterproductive manner. It focuses on the mechanisms being activated as the result of socio-technical interactions of health care environment with HIT and presents these mainly in the form of silent or latent errors in the course of care practices. One of the great advantages of using HITs is that patient data can be stored and saved for use along the patient trajectory. Three interconnected mechanisms are of concern which comes into effect through working with HIT. They are: interoperability impeding, dissociation of virtual and real practices, and workflow impeding. Each mechanism is described and supplemented with examples from health care practice. The chapter illustrates these mechanisms with excerpts taken from observations of medication information systems in use and who have analysed similar practices in widely differing health care systems.