Effects of a bidirectional interoperability between electronic health records and smart infusion pumps in hospital settings: a systematic review.

Abstract

To explore the effects of bidirectional interoperability between electronic health records (EHR) and smart infusion pumps on medication errors (MEs), system compliance and workflow efficiency and economic aspects. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 criteria. The literature search on Scopus, MEDLINE (Ovid), Web of Science, Cumulated Index in Nursing and Allied Health Literature, and Evidence-Based Medicine Reviews was conducted on 3 October 2024. Peer-reviewed studies considering bidirectional interoperability between EHR and smart pumps in hospitals were included. Study selection according to a predetermined Population, Intervention, Comparison(s) and Outcome tool, data extraction and evidence quality assessment (Joanna Briggs Institute critical appraisal tool assessment and the Grading of Recommendations Assessment, Development and Evaluation approach) were carried out by two individual reviewers. Seven studies from the USA, published between 2011 and 2024, were included. The studies used variable designs to compare the effects of bidirectional interoperability between smart infusion pumps and EHR on system compliance and workflow efficiency (n=6 studies), MEs (n=3) and economic outcomes (n=2) before and after implementation. The observed effects were mainly positive; however, evidence quality was low because of the observational nature of studies. The interoperability between EHR systems and smart infusion pumps remains a relatively novel research topic. Evidence is geographically concentrated, limiting its generalisability to different healthcare systems, regulatory environments and technology adoption patterns. While bidirectional interoperability may reduce MEs, improve system compliance and workflow efficiency and enhance hospitals' charging accuracy of provided care, future studies should prioritise controlled designs, robust data and economic outcomes to justify the investment. CRD42024538518.