cognitive ergonomics, socio-technical systems, and the impact of healthcare information technologies

the united states healthcare system is transitioning from paper-based to computer-based systems. in this process, it is vitally important to focus on optimizing the role of human factors in systems design. this review examines a wide range of cognitive ergonomics and socio-technical systems issues that impact the successful implementation of healthcare information technologies (hit). we review evidence on the impact of hit on medication errors, electronic health records and clinical support, copying clinical exams and notes, computerized-provider order entry and clinical decision support system, and bar-code medication administration systems. we examine research on barriers to successful hit implementation and also on user workarounds of systems’ limitations. the review concludes by summarizing a series of important human factors design considerations that must be considered for successful systems implementation. this information is presented in a manner that should allow hit system designers and implementers to readily incorporate these principles into their future developments. relevance to industry: evidence from a comprehensive review of the impact of hit on a wide variety of important healthcare issues is presented and a series of human factors design considerations that are critical to successful hit systems design is summarized.