May 2013

Document Type


Degree Name



Dept. of Medical Informatics and Clinical Epidemiology


Oregon Health & Science University


Throughout the United States health care industry, early-generation clinical systems are being rapidly replaced with integrated and certified systems, in a rush to meet “meaningful use” goals and capture federal funding. Emergency departments and other clinical areas were early adopters of specialty-specific information systems, but they are now being mandated to abandon those systems and adopt enterprise systems. Many of the enterprise systems do not have the same maturity as the departmental systems, and are not as finely adapted to ED workflow. This rapid cycle of change is driven almost entirely by enterprise financial concerns that are external to the ED, rather than by clinician dissatisfaction with the existing system. The effect of this enormous system replacement undertaking is uncertain. It may have positive or negative effects on throughput, quality of documentation, quality of care, or patient safety. Clinicians may experience stress around the need to abandon familiar to




School of Medicine



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