Guide to Reducing Unintended Consequences of Electronic Health Records

Healthcare professionals using an electronic health record device

The Guide to Reducing Unintended Consequences of Electronic Health Records is an online resource designed to help you and your organization anticipate, avoid, and address problems that can occur when implementing and using an electronic health record (EHR). Our purpose in developing the Guide was to provide practical, troubleshooting knowledge and resources.

The Guide was developed with all types of health care organizations in mind — from large hospital systems to solo physician practices. We anticipate that the primary users will be EHR implementers such as Regional Extension Centers, chief information officers, directors of clinical informatics, EHR champions or "super users," administrators, information technology specialists, and clinicians involved in the implementation of an EHR. Frontline EHR users (such as physicians and nurses) may also find the Guide useful.

The Guide is based on the research literature, other practice-oriented guides for EHR implementation and use, research by its authors, and interviews with organizations that have recently implemented EHR. The Guide represents a compilation of the known best practices for anticipating, avoiding, and addressing EHR-related unintended consequences. However, this area of research is still in its infancy. Therefore, the Guide is a work in progress. We invite you to revise its tools and recommendations in keeping with your own experience and in response to emerging research findings.


The RAND Corporation prepared the Guide for the Agency for Healthcare Research and Quality under contract HHSA290200600017I, Task Order #5. The authors of the Guide are Spencer S. Jones, Ross Koppel, M. Susan Ridgely, Ted E. Palen, Shinyi Wu, and Michael I. Harrison.
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Note: The Guide represents the opinions of the authors and does not necessarily represent the opinions or best practice recommendations of the Agency for Healthcare Research and Quality, the United States Government, or any of the other organizations with which the authors are affiliated.
Learn more about the organizations and individuals who contributed to the development of the Guide »

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