{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:47:31Z","timestamp":1774950451407,"version":"3.50.1"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Veterans Administration (VA) Health Services Research and Development (HSR&D) Service","award":["IIR17-127"],"award-info":[{"award-number":["IIR17-127"]}]},{"name":"Presidential Early Career Award for Scientists and Engineers USA","award":["14-274"],"award-info":[{"award-number":["14-274"]}]},{"DOI":"10.13039\/100015620","name":"Center for Innovations in Quality, Effectiveness, and Safety","doi-asserted-by":"crossref","award":["CIN13-413"],"award-info":[{"award-number":["CIN13-413"]}],"id":[{"id":"10.13039\/100015620","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS27363"],"award-info":[{"award-number":["R01HS27363"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000936","name":"Gordon and Betty Moore Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Over the next decade, many health care organizations (HCOs) will transition from one electronic health record (EHR) to another; some forced by hospital acquisition and others by choice in search of better EHRs. Herein, we apply principles of Requisite Imagination, or the ability to imagine key aspects of the future one is planning, to offer 6 recommendations on how to proactively safeguard these transitions. First, HCOs should implement a proactive leadership structure that values communication. Second, HCOs should implement proactive risk assessment and testing processes. Third, HCOs should anticipate and reduce unwarranted variation in their EHR and clinical processes. Fourth, HCOs should establish a culture of conscious inquiry with routine system monitoring. Fifth, HCOs should foresee and reduce information access problems. Sixth, HCOs should support their workforce through difficult EHR transitions. Proactive approaches using Requisite Imagination principles outlined here can help ensure safe, effective, and economically sound EHR transitions.<\/jats:p>","DOI":"10.1093\/jamia\/ocab291","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T04:23:48Z","timestamp":1640838228000},"page":"1014-1018","source":"Crossref","is-referenced-by-count":13,"title":["Applying requisite imagination to safeguard electronic health record transitions"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5811-8915","authenticated-orcid":false,"given":"Dean F","family":"Sittig","sequence":"first","affiliation":[{"name":"University of Texas\/Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priti","family":"Lakhani","sequence":"additional","affiliation":[{"name":"Formerly at Office of Electronic Health Record Modernization, U.S. Department of Veterans Affairs, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4419-8974","authenticated-orcid":false,"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"issue":"7","key":"2022041311575219100_ocab291-B1","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1093\/jamia\/ocz021","article-title":"The complex case of EHRs: examining the factors impacting the EHR user experience","volume":"26","author":"Tutty","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2022041311575219100_ocab291-B2","first-page":"24","article-title":"Making the EHR switch","volume":"23","author":"Slabodkin","year":"2015","journal-title":"Health Data Manag"},{"key":"2022041311575219100_ocab291-B3","author":"Holmgren","year":"2019"},{"key":"2022041311575219100_ocab291-B4","year":"2017"},{"key":"2022041311575219100_ocab291-B5","author":"Drees","year":"2021"},{"key":"2022041311575219100_ocab291-B6","author":"Milliard","year":"2018"},{"key":"2022041311575219100_ocab291-B7","author":"Arndt","year":"2018"},{"key":"2022041311575219100_ocab291-B8","author":"Drees","year":"2021"},{"issue":"5","key":"2022041311575219100_ocab291-B9","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/jamia\/ocy007","article-title":"Changes in hospital bond ratings after the transition to a new electronic health record","volume":"25","author":"McEvoy","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2022041311575219100_ocab291-B10","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1055\/s-0040-1718535","article-title":"Transitions from one electronic health record to another: challenges, pitfalls, and recommendations","volume":"11","author":"Huang","year":"2020","journal-title":"Appl Clin Inform"},{"issue":"5S","key":"2022041311575219100_ocab291-B11","first-page":"S13","article-title":"Electronic health record transition considerations","volume":"9","author":"Penrod","year":"2017","journal-title":"Phys Med Rehabil"},{"key":"2022041311575219100_ocab291-B12"},{"key":"2022041311575219100_ocab291-B13","author":"Philipps","year":"2021"},{"key":"2022041311575219100_ocab291-B14","year":"2021"},{"key":"2022041311575219100_ocab291-B15","year":"2021"},{"issue":"9","key":"2022041311575219100_ocab291-B16","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s10916-018-1023-5","article-title":"An EPIC switch: observations and opportunities after go-live","volume":"42","author":"Johnson","year":"2018","journal-title":"J Med Syst"},{"key":"2022041311575219100_ocab291-B17","author":"Flanagan","year":"2016"},{"issue":"2","key":"2022041311575219100_ocab291-B18","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/jamia\/ocz193","article-title":"Lessons learned implementing a complex and innovative patient safety learning laboratory project in a large academic medical center","volume":"27","author":"Businger","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"2022041311575219100_ocab291-B19","doi-asserted-by":"crossref","first-page":"i68","DOI":"10.1136\/qshc.2010.042085","article-title":"A new sociotechnical model for studying health information technology in complex adaptive healthcare systems","volume":"19 (Suppl 3","author":"Sittig","year":"2010","journal-title":"Qual Saf Healthc"},{"issue":"2","key":"2022041311575219100_ocab291-B20","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1002\/jhrm.21434","article-title":"How can we partner with electronic health record vendors on the complex journey to safer health care?","volume":"40","author":"Sittig","year":"2020","journal-title":"J Healthc Risk Manag"},{"issue":"1","key":"2022041311575219100_ocab291-B21","first-page":"17","article-title":"Health care as a complex adaptive system: implications for design and management","volume":"38","author":"Rouse","year":"2008","journal-title":"The Bridge"},{"key":"2022041311575219100_ocab291-B22","first-page":"193","volume-title":"Handbook of Cognitive Task Design","author":"Adamski","year":"2003"},{"issue":"3","key":"2022041311575219100_ocab291-B23","doi-asserted-by":"crossref","first-page":"318","DOI":"10.4338\/ACI-2012-03-RA-0006","article-title":"An integrated EHR at Northern California Kaiser Permanente: pitfalls, challenges, and benefits experienced in transitioning","volume":"3","author":"Bornstein","year":"2012","journal-title":"Appl Clin Inform"},{"issue":"5","key":"2022041311575219100_ocab291-B24","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1055\/s-0040-1716537","article-title":"Application of human factors methods to understand missed follow-up of abnormal test results","volume":"11","author":"Rogith","year":"2020","journal-title":"Appl Clin Inform"},{"issue":"2","key":"2022041311575219100_ocab291-B25","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1136\/jamia.2000.0070116","article-title":"Managing change: an overview","volume":"7","author":"Lorenzi","year":"2000","journal-title":"J Am Med Inform Assoc"},{"key":"2022041311575219100_ocab291-B26","first-page":"765","article-title":"Migrating from one comprehensive commercial EHR to another: perceptions of front-line clinicians and staff","volume":"2019","author":"Reynolds","year":"2020","journal-title":"AMIA Annu Symp Proc"},{"issue":"4","key":"2022041311575219100_ocab291-B27","doi-asserted-by":"crossref","first-page":"3140","DOI":"10.1177\/1460458219833109","article-title":"Essential activities for electronic health record safety: a qualitative study","volume":"26","author":"Ash","year":"2020","journal-title":"Health Informatics J"},{"issue":"11","key":"2022041311575219100_ocab291-B28","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.ijmedinf.2012.04.003","article-title":"Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites","volume":"81","author":"Wright","year":"2012","journal-title":"Int J Med Inform"},{"issue":"3","key":"2022041311575219100_ocab291-B29","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/amiajnl-2011-000113","article-title":"Development and evaluation of a comprehensive clinical decision support taxonomy: comparison of front-end tools in commercial and internally developed electronic health record systems","volume":"18","author":"Wright","year":"2011","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2022041311575219100_ocab291-B30","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1093\/jamia\/ocv013","article-title":"Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems","volume":"22","author":"Sittig","year":"2015","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2022041311575219100_ocab291-B31","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1197\/jamia.M2616","article-title":"Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety","volume":"15","author":"Koppel","year":"2008","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2022041311575219100_ocab291-B32","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1055\/s-0040-1721398","article-title":"Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems","volume":"11","author":"Friebe","year":"2020","journal-title":"Appl Clin Inform"},{"issue":"03","key":"2022041311575219100_ocab291-B33","doi-asserted-by":"crossref","first-page":"866","DOI":"10.4338\/ACI-2017-04-RA-0059","article-title":"Comparison of overridden medication-related clinical decision support in the intensive care unit between a commercial system and a legacy system","volume":"08","author":"Wong","year":"2017","journal-title":"Appl Clin Inform"},{"key":"2022041311575219100_ocab291-B34"},{"issue":"10","key":"2022041311575219100_ocab291-B35","first-page":"540","article-title":"Toward more proactive approaches to safety in the Electronic Health Record Era","volume":"43","author":"Sittig","year":"2017","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"15","key":"2022041311575219100_ocab291-B36","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1001\/jama.2021.13945","article-title":"Policies to promote shared responsibility for safer electronic health records","volume":"326","author":"Sittig","year":"2021","journal-title":"JAMA"},{"issue":"1","key":"2022041311575219100_ocab291-B37","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1093\/jamia\/ocw039","article-title":"Testing electronic health records in the \u201cproduction\u201d environment: an essential step in the journey to a safe and effective health care system","volume":"24","author":"Wright","year":"2017","journal-title":"J Am Med Inform Assoc"},{"key":"2022041311575219100_ocab291-B38","volume-title":"Basic Statistical Tools for Improving Quality","author":"Kvam","year":"2011"},{"issue":"1","key":"2022041311575219100_ocab291-B39","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1197\/jamia.M2184","article-title":"Controversies surrounding use of order sets for clinical decision support in computerized provider order entry","volume":"14","author":"Bobb","year":"2007","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2022041311575219100_ocab291-B40","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s10916-017-0865-6","article-title":"An EPIC switch: preparing for an electronic health record transition at Vanderbilt University Medical Center","volume":"42","author":"Johnson","year":"2017","journal-title":"J Med Syst"},{"issue":"5","key":"2022041311575219100_ocab291-B41","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1197\/jamia.M2042","article-title":"Types of unintended consequences related to computerized provider order entry","volume":"13","author":"Campbell","year":"2006","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2022041311575219100_ocab291-B42","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1136\/amiajnl-2013-002578","article-title":"An analysis of electronic health record-related patient safety concerns","volume":"21","author":"Meeks","year":"2014","journal-title":"J Am Med Inform Assoc"},{"key":"2022041311575219100_ocab291-B43","doi-asserted-by":"crossref","first-page":"103343","DOI":"10.1016\/j.jbi.2019.103343","article-title":"EHR audit logs: a new goldmine for health services research?","volume":"101","author":"Adler-Milstein","year":"2020","journal-title":"J Biomed Inform"},{"issue":"6","key":"2022041311575219100_ocab291-B44","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1542\/peds.2005-1287","article-title":"Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system","volume":"116","author":"Han","year":"2005","journal-title":"Pediatrics"},{"issue":"3","key":"2022041311575219100_ocab291-B45","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.annemergmed.2013.08.019","article-title":"Transient and sustained changes in operational performance, patient evaluation, and medication administration during electronic health record implementation in the emergency department","volume":"63","author":"Ward","year":"2014","journal-title":"Ann Emerg Med"},{"key":"2022041311575219100_ocab291-B46","year":"2016"},{"issue":"6","key":"2022041311575219100_ocab291-B47","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1093\/jamia\/ocaa026","article-title":"Is a switch to a different electronic health record associated with a change in patient satisfaction?","volume":"27","author":"North","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2022041311575219100_ocab291-B48","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/jamia\/ocw153","article-title":"Safety huddles to proactively identify and address electronic health record safety","volume":"24","author":"Menon","year":"2017","journal-title":"J Am Med Inform Assoc"},{"issue":"7","key":"2022041311575219100_ocab291-B49","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1093\/jamia\/ocy041","article-title":"Using statistical anomaly detection models to find clinical decision support malfunctions","volume":"25","author":"Ray","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2022041311575219100_ocab291-B50","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1055\/s-0041-1726032","article-title":"Defining data migration across multidisciplinary ambulatory clinics using participatory design","volume":"12","author":"MacKenzie","year":"2021","journal-title":"Appl Clin Inform"},{"issue":"5","key":"2022041311575219100_ocab291-B51","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1093\/jamia\/ocv173","article-title":"A rational approach to legacy data validation when transitioning between electronic health record systems","volume":"23","author":"Pageler","year":"2016","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2022041311575219100_ocab291-B52","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1056\/NEJMp1106313","article-title":"Incomplete care \u2013 on the trail of flaws in the system","volume":"365","author":"Gandhi","year":"2011","journal-title":"N Engl J Med"},{"issue":"7","key":"2022041311575219100_ocab291-B53","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1093\/jamia\/ocab039","article-title":"Clinical data sharing improves quality measurement and patient safety","volume":"28","author":"D'Amore","year":"2021","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2022041311575219100_ocab291-B54","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1136\/amiajnl-2014-002988","article-title":"Patient safety goals for the proposed Federal Health Information Technology Safety Center","volume":"22","author":"Sittig","year":"2015","journal-title":"J Am Med Inform Assoc"},{"key":"2022041311575219100_ocab291-B55","author":"Donovan-Smith","year":"2021"},{"issue":"6","key":"2022041311575219100_ocab291-B56","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1093\/jamia\/ocx094","article-title":"Implementing electronic health records (EHRs): health care provider perceptions before and after transition from a local basic EHR to a commercial comprehensive EHR","volume":"25","author":"Krousel-Wood","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2022041311575219100_ocab291-B57","doi-asserted-by":"crossref","first-page":"994","DOI":"10.4338\/ACI-2016-04-RA-0069","article-title":"How physician perspectives on e-prescribing evolve over time. A case study following the transition between EHRs in an outpatient clinic","volume":"7","author":"Abramson","year":"2016","journal-title":"Appl Clin Inform"},{"issue":"3","key":"2022041311575219100_ocab291-B58","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/amiajnl-2013-001771","article-title":"A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success","volume":"21","author":"Wright","year":"2014","journal-title":"J Am Med Inform Assoc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/5\/1014\/43372323\/ocab291.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/5\/1014\/43372323\/ocab291.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T12:12:52Z","timestamp":1649851972000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/29\/5\/1014\/6504033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,12]]},"references-count":58,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,1,12]]},"published-print":{"date-parts":[[2022,4,13]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocab291","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2022,1,12]]}}}