Abstract
Background According to Digital Health Canada 2013 eSafety Guidelines, an estimated one-third
of patient safety incidents following implementation of clinical information systems
(CISs) are technology-related. An eSafety checklist was previously developed to improve
CIS safety by providing a comprehensive listing of system-agnostic, evidence-based
configuration recommendations.
Objectives We sought to use the checklist to support safe initial configuration of a provincial
system-wide CIS (Alberta, Canada), referred to as Connect Care.
Methods The checklist was applied to 13 Connect Care modules in three successive phases.
First, the checklist was adapted to an abbreviated high-priority version. Second,
demonstrations of each module were recorded. Finally, independent evaluation of each
recording was conducted by two eSafety evaluators using the abbreviated eSafety checklist.
Results All modules achieved greater than 72% compliance, with an average of 84%. Overall,
273 opportunities for improvement were identified, with four major areas or themes
emerging: (1) inconsistent date and time, (2) unclear patient identification, (3)
ineffective alert system, and (4) insufficient decision support. These opportunities
were forwarded to the appropriate build teams for review and implementation.
Conclusion This work is the first to utilize the eSafety checklist in a real-world CIS, which
will become one of the largest in Canada. The checklist has shown clinical applicability
in identifying gaps in CIS configuration and should be considered for use in future
and pre-existing CISs.
Keywords
electronic health records - patient safety - informatics - information systems
