Unintended consequences of health information technology: A need for biomedical informatics

Professor and Chair Department of Biomedical Informatics, University of Pittsburgh School ofMedicine, Pittsburgh, PAIn all science, error precedes the truth, and it is better it should go first than last.-- Sir Hugh Walpole (English novelist, 1884–1941)Health information technology (HIT) can address important problems in clinical care andbiomedical research. These problems include lack of compliance with clinical practiceguidelines [1], insufficient use of preventative medicine services [2] and numerousimpediments to clinical/translational research [ 3]. However, front-line patient care informationsystems that can influence care may worsen outcomes as well as improve them. Increasingly,there is evidence of significant, unintended and deleterious effects of well-meaning HIT efforts[4]. In this paper we present examples of such deleterious effects and argue that: 1) HIT is atool that can influence health care and biomedicine (for good or ill) and 2) biomedicalinformatics efforts are needed to ensure that HIT fulfills its promise in biomedicine.