To date, studies have generally been conducted only in individual facilities and rarely in the outpatient setting; moreover, only a few types of technology have been well tested. However, the large benefits found in the improvement of fundamental aspects of patient care8,12,13,16-18 indicate that information technology can be an important tool for improving safety in many clinical settings.
Tools that can improve communication, make knowledge more accessible, require key information, and assist with calculations and clinical decision making are available today and should provide substantial benefit. More research is needed on such questions as how best to perform checks, how best to assist in monitoring, and especially, how to provide decision support most effectively in complex situations. In today's systems, many important warnings are ignored,42 and there are too many unimportant warnings. Approaches have been developed to highlight more serious warnings — for instance, by displaying a skull and crossbones — when a clinician tries to order a drug that has previously caused an anaphylactic reaction in the patient.
However, many efforts directed at complex targets such as the management of hypertension44 or congestive heart failure45 have failed. Overcoming these difficulties will require bringing cognitive engineers and techniques for assessing and accommodating human factors, such as usability testing, into the design of medical processes.