Many unintended and undesired consequences of Healthcare Information Technologies (HIT) flow from interactions between the HIT and the healthcare organization's sociotechnical system-its workflows, culture, social interactions, and technologies. This paper develops and illustrates a conceptual model of these processes that we call Interactive Sociotechnical… (More)
The authors develop a typology of clinicians' workarounds when using barcoded medication administration (BCMA) systems. Authors then identify the causes and possible consequences of each workaround. The BCMAs usually consist of handheld devices for scanning machine-readable barcodes on patients and medications. They also interface with electronic medication… (More)
The current commercial health information technology (HIT) arena encompasses a number of competing firms that provide electronic health applications to hospitals, clinical practices, and other healthcare-related entities. Such applications collect, store, and analyze patient information. Some vendors incorporate contract language whereby purchasers of HIT… (More)
OBJECTIVE To model inconsistencies or distortions among three realities: patients' physical reality; clinicians' mental models of patients' conditions, laboratories, etc; representation of that reality in electronic health records (EHR). To serve as a potential tool for quality improvement of EHRs. METHODS Using observations, literature, information… (More)
In real world domains, from healthcare to power to finance, computer systems are deployed with the intention of streamlining and improving the activities of human agents in the corresponding non-cyber worlds. However, talking to actual users (instead of just computer security experts) reveals endemic circumvention of the computer-embedded rules.… (More)
Agent-based modeling can serve as a valuable asset to security personnel who wish to better understand the security landscape within their organization, especially as it relates to user behavior and circumvention. In this paper, we argue in favor of cognitive behavioral agent-based modeling for usable security, report on our work on developing an… (More)
A survey of members of the American Medical Informatics Association (AMIA) listserv Forum on implementation and optimization asked how members perceived the Forum, and suggestions for improvement. Respondents appear to be remarkably engaged with the Forum's debates, information sharing, educational and practical teachings, comments, and immediacy.