112 Healthcare Quarterly Vol.11 No.1 2008
It is recognized that the electronic health record (EHR) has
significant potential to improve patient safety in Canada.
However, the scientific evidence connecting EHRs to improve-
ments in patient safety is incomplete. Additionally, interna-
tional experience has demonstrated that EHRs trigger profound
cultural and organizational changes in healthcare delivery.
Consequently, Canada has a unique opportunity to learn from
A three-way partnership was established between Canada
Health Infoway, the Canadian Patient Safety Institute (CPSI)
and the Integrated Centre for Care Advancement through
Research (iCARE) to explore opportunities for enhancing
patient safety through the implementation and use of EHRs.
The exploratory efforts included gathering information from
three main sources. First, an initial literature scan of over 300
peer-reviewed and non-peer-reviewed documents pertaining to
EHRs and patient safety was conducted. Of these documents,
135 were examined in detail.
Next, 28 semi-structured interviews with key stakeholders
in the field of EHRs and patient safety were conducted and
analyzed using a purposive sampling strategy. These stakeholders
– key Canadian and international researchers, clinicians and
policy makers in the fields of EHRs and patient safety – were
asked about the following:
• Their role as a stakeholder and how it relates to EHRs or
• Their definition of an EHR
• The relationship between EHRs and patient safety
• The linkage(s) between EHRs and patient safety in their
• Any gaps in knowledge for EHRs and patient safety
• Their suggested next steps to advance the EHR and patient
Data from these interviews were then analyzed and combined
with relevant information from the literature scan and presented
in a briefing paper titled “EHRs and Patient Safety: Evidence,
Issues, and Future Directions” (Grimm et al. 2007).
Finally, selected stakeholders (including