In a previous Pennsylvania Patient Safety Advisory article, analysts read 3,099 narrative reports relevant to health information technology (HIT) from the Pennsylvania Patient Safety Authority's database and tagged each report using a previously published classification taxonomy developed specifically for HIT. In the course of that review, analysts identified 85 reports of a specific type of error: errors related to miscommunication arising from dual use of electronic and paper documentation. The use of a hybrid workflow, in which both electronic and paper systems are used for documentation, is often found in care areas transitioning from a paper-based to fully electronic (i.e., electronic health record [EHR]) documentation procedure. Hybrid workflows may occur as a planned transitional step during the implementation of an EHR system or may arise as a workaround in which paper is used to supplement electronic systems. This article describes the type of events related to the use of a hybrid workflow and provides recommendations on reducing the use of hybrid workflows.
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