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Table 2 Workarounds and user-perceived benefits and risks

From: Persisting workarounds in Electronic Health Record System use: types, risks and benefits

Category Workaround Identification Benefits Risks
In-system workflow sequence workarounds Ignoring pop-ups Interview (5x) NU, PH Improved workflow (U), time savings (U) Jeopardize patient safety (P), false sense of safety (P)
Pre-starting a patient’s visit Observation (2x), interview (2x) PH Improved workflow (U) Incorrect billing (H)
In-system data entry workarounds Copy-pasting Observation (2x), interview (7x) PH, SS, MA Improved workflow (U), time savings (U), better overview (U) Extra work (U), loss of potential system support (S), hindering research (H)
Using separate text fields Interview (8x) NU, PH, SS Better overview (U) Hindering research (U), loss of overview (U)
Leaving data fields empty Observation (1x), interview (5x) PH Improved workflow (U), time savings (U) Loss of potential system support (S), cascading errors (P)
Sharing login details Interview (5x) SS Improved workflow (U) Abuse of details (U), jeopardize patient safety (P)
Entering incorrect data Interview (2x) NU, PH Improved workflow (U) False sense of safety (P)
Out-system workaround Using paper Observation (1x), interview (12x) NU, PH, SS, MA Improved workflow (U), increased patient contact (P) Extra work (U), loss of data (U), loss of overview (U), jeopardize patient safety (P)
Using shadow systems Interview (6x) PH, SS, MA Better overview (U), improved workflow (P), improvements of the system (S) Extra work (U), system not up-to-date (S)
Giving verbal consent for dispensing medication Interview (3x) NU, PH Improved workflow (U), time savings (U), improved patient care (P) System not up-to-date (S), cascading errors (P)
Separating a scanner from its COW Interview (1x) NU Improved patient care (P) Jeopardize patient safety (P)
  1. Codes in identification column indicate who reported the workaround: NU = nurse; PH = physician; SS = support team member; MA = medical administrator. Codes attached to benefits and risks indicate to whom the users think these consequences apply: U = user; P = patient; S = system; H = hospital