Table 1

Sociotechnical dimensions21 comprising the ‘structure’ of the Safer Dx framework

Hardware and softwareComputing infrastructure used to support and operate clinical applications and devices
Clinical contentThe text, numeric data and images that constitute the ‘language’ of clinical applications
Human–computer interfaceAll aspects of technology that users can see, touch or hear as they interact with it
PeopleEveryone who is involved with patient care and/or interacts in some way with healthcare delivery (including technology). This would include patients, clinicians and other healthcare personnel, information technology (IT) developers and other IT personnel and informaticians
Workflow and communicationProcesses to ensure that patient care is carried out effectively
Internal organisational featuresPolicies, procedures, work environment and culture
External rules and regulationsFederal or state rules (eg, CMS's Physician Quality Reporting Initiative22 or requirements for associating a diagnosis with a request for a diagnostic test23) that facilitate or constrain preceding dimensions
Measurement and monitoringProcesses to evaluate both intended and unintended consequences
  • CMS, Centers for Medicare & Medicaid Services.