title: National efforts to improve health information system safety in Canada, the United States of America and England.
abstract: OBJECTIVE
  In this paper we review progress as well as challenges encountered in Canada, the United States and England with regard to ensuring safety of health information technology.
  
  
  METHODS
  A review of major programs and initiatives for ensuring safety of health information technology in the three countries was conducted. Published literature and Web resources from national programs were reviewed for relevant information.
  
  
  RESULTS
  It was found that in all three countries the issue of technology-induced error has been recognized as being of critical importance. The three countries have developed approaches for dealing with the issue that have some commonalities; however, they are at varying different stages of maturity, with England having the longest standing and most well developed safety programs, while Canada and the United States are at earlier stages. The types of approaches employed have included work on developing standards related to usability and interface design, certifications, directives from regulatory bodies, educational initiatives in health information technology (HIT) safety as well as research into safer HIT design and implementation methods.
  
  
  CONCLUSIONS
  HIT promises to lead to improved patient safety. However, it has become recognized that if not designed and deployed appropriately, such systems can lead to new types of errors. Based on this recognition, a variety of initiatives are being undertaken in Canada, the United States and England to promote the safe design, procurement and deployment of HIT. It is concluded that improved approaches to system design, testing, regulation, error reporting, safety education and cross-country collaboration will be needed to further promote safer HIT.
authors: School of Health Information Science, University of Victoria, PO Box 3050, STN CSC, Victoria, British Columbia V8W 3P5, Canada. andrek@uvic.ca
authors: Andre W
authors: AW
authors: Kushniruk
authors: David W
authors: DW
authors: Bates
authors: Michael
authors: M
authors: Bainbridge
authors: Mowafa S
authors: MS
authors: Househ
authors: Elizabeth M
authors: EM
authors: Borycki
mesh_terms: D002170:Canada; D003695:Delivery of Health Care / Q000592:standards*; D057286:Electronic Health Records / Q000458:organization & administration / Q000706:statistics & numerical data*; D004739:England; D063005:Health Information Systems / Q000458:organization & administration / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D061214:Patient Safety / Q000331:legislation & jurisprudence / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States