Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.


Healthcare outcomes can be improved and efficiency increased by clinical systems. Healthcare leaders and informaticists need to keep up to date with the most recent technology developments and review existing research in order to develop effective clinical systems strategies. Five peer-reviewed papers that examine the use of clinical systems for improving outcomes and efficiency are reviewed in this paper.

A selection of peer-reviewed articles:

  1. Greenhalgh et al. (2018) – “Personal health records and portal for people with diabetes: a systematic review and evaluation.”
  2. Foster et al. (2018) – “The Impact of Electronic Health Records on Patient Safety: A Qualitative Exploratory Study.”
  3. Hefner et al. (2016) – “Personal health record use and its association with diabetes adherence and A1C control.”
  4. Unertl et al. (2018) – “A review of cybersecurity incidents in healthcare.”
  5. Jones et al. (2019) – “Electronic health record usability issues and potential contribution to patient harm.”

Article Summary:

  1. Greenhalgh et al. (2018) conducted an analysis of diabetes portals and personal health records. A total of 31 studies were analyzed. Seventeen showed significant improvement in diabetes management results, including A1C, self-management and patient satisfaction.
  2. Foster et al. Foster et al. (2018) carried out a qualitative exploratory research to determine the effects of EHRs on patient safety. EHRs are able to facilitate communication and support clinical decision-making. They also provide access to the most current information. This study concludes that EHRs improve patient safety. EHRs may also present safety issues, like alert fatigue, documentation mistakes, and document errors.
  3. Hefner et al. A study was conducted by Hefner and colleagues (2016) to examine the link between diabetes compliance and A1C management. Data from 162 diabetic patients were analysed and PHR users demonstrated significantly greater adherence and A1C control.
  4. Unertl et al. (2018) reviewed cybersecurity incidents in healthcare. They identified 100 incidents that led to a breach in protected health information (PHI). The incidents occurred between 2009 and 2017. According to the review, hacking and IT incidents were the leading causes of breaches of patient health information (PHI). The most frequent type of breached PHI was demographic data.
  5. Jones et al. Jones et al. (2019) performed a study in order to determine EHR usability problems that could lead to patient harm. This study examined 1,735 patient safety incidents and found 557 that could be attributed to EHR useability problems. EHR problems can lead to many patient safety issues, such as errors in diagnosis, medication, or delays in treatment.


Research has shown that clinical systems such as EHRs and PHRs can help improve efficiency and healthcare outcomes. These studies show that clinical systems may present new safety and usability risks that need to be addressed by informaticists as well as healthcare leaders. The reviewed articles provide valuable information that can be used to help develop clinical system strategies that balance technology and healthcare benefits.

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