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. Informatists and leaders in healthcare must keep abreast of the latest technological trends, and refer to existing research for effective strategies to improve clinical systems. Five peer-reviewed papers that examine the use of clinical systems for improving outcomes and efficiency are reviewed in this paper.

Select Articles that have been peer-reviewed

  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 summaries

  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 improvements in diabetes management. These included A1C control, 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 have the potential to improve patient safety through facilitating communication, clinical decision-making support, and accessing up-to-date data. 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 PHR usage and A1C control. Study data were analyzed from 162 diabetes patients. It was found that PHR users showed significantly higher levels of adherence and A1C management than those who did not use them.
  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. (2018) conducted a review of cybersecurity incidents in healthcare and identified 100 cybersecurity incidents that resulted in a breach of protected health information (PHI) between 2009 and 2017.
  5. Jones et al. Jones et al. (2019) performed a study in order to determine EHR usability problems that could lead to patient harm. Study of 1,735 incidents of patient harm was done. 557 cases were identified as being related to EHR issues. EHR issues could lead to patient safety incidents such as medication errors and diagnostic errors.


Research has shown that clinical systems such as EHRs and PHRs can help improve efficiency and healthcare outcomes. Studies also show how clinical systems pose safety issues and can be difficult to use. This is something that informaticists should pay attention to. 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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