J Am Med Inform Assoc 17:617-623 doi:10.1136/jamia.2010.005637
  • Viewpoint paper

Health information technology: fallacies and sober realities

  1. Robert L Wears6,7
  1. 1Department of Industrial and Systems Engineering and Systems Engineering Initiative for Patient Safety, University of Wisconsin, Madison, Wisconsin, USA
  2. 2Center for Perioperative Research in Quality, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  3. 3Geriatrics Research, Education, and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA
  4. 4Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  5. 5Department of Health Systems and Outcomes, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
  6. 6Department of Emergency Medicine, University of Florida, Jacksonville, Florida, USA
  7. 7Clinical Safety Research Unit, Imperial College London, London, UK
  1. Correspondence to Ben-Tzion Karsh, Department of Industrial and Systems Engineering and Systems Engineering Initiative for Patient Safety, University of Wisconsin, 1513 University Avenue, Room 3218, Madison, WI 53706, USA; bkarsh{at}
  • Received 30 April 2010
  • Accepted 1 September 2010


Current research suggests that the rate of adoption of health information technology (HIT) is low, and that HIT may not have the touted beneficial effects on quality of care or costs. The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. We discuss 12 HIT fallacies and their implications for design and implementation. These fallacies must be understood and addressed for HIT to yield better results. Foundational cognitive and human factors engineering research and development are essential to better inform HIT development, deployment, and use.


  • This paper stemmed from the authors' participation as external resources in a workshop sponsored by the Agency for Healthcare Research and Quality (AHRQ) entitled ‘Wicked Problems in Cutting Edge Computer-Based Decision Support’ held on March 26–27, 2009 at the Center for Better Health, Vanderbilt University, Nashville, Tennessee.

  • Funding The authors' time has been supported by grants R18SH017899 from AHRQ and R01LM008923-01A1 from NIH to BK; IAF06-085 from the Department of Veterans Affairs Health Services Research and Development Service (HSR&D) and HS016651 from AHRQ to MBW; and R18HS017902 from AHRQ to RLW.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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