Unintended Adverse Consequences of Health IT Implementation: Workflow Issues and Their Cascading Effects

The implementation of health information technology (IT) in clinical settings can introduce adverse effects to workflow, such as new or increased work, interruptions and distractions, delays or inefficiencies, duplicated work practices, and changed or disrupted communication. These adverse effects, if not managed properly, can result in increased clinician cognitive load and escalated patient safety risks. In this chapter, we summarize the literature on unintended adverse consequences of health IT related to clinical workflow. Based on prior research, we categorize these effects as primary and secondary unintended consequences to conceptualize the workflow issues and their cascading effects. By considering workflow issues as primary consequences and beginning to unpack the complex relationship between these issues and their impact on clinical work, we can better anticipate and address the adverse effects associated with health IT implementation.