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Preprint . 2026
License: CC BY
Data sources: Datacite
ZENODO
Preprint . 2026
License: CC BY
Data sources: Datacite
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CGS Paper 4 – System Failure Modes in Healthcare Digitalization: Why Well-Designed Technologies Produce Clinically Fragile Systems

Authors: Domargård, Anita;

CGS Paper 4 – System Failure Modes in Healthcare Digitalization: Why Well-Designed Technologies Produce Clinically Fragile Systems

Abstract

This paper examines why well-designed digital technologies in healthcare repeatedly produce clinically fragile systems. Rather than attributing failure to poor implementation, resistance to change, or insufficient training, the analysis identifies recurring system failure modes that arise when healthcare is treated as an optimisable technical domain rather than a complex clinical system. Drawing on systems theory and empirical experience from large-scale healthcare digitalisation, the paper describes how digital systems disrupt clinical flow, externalise cognitive and organisational load, misalign governance, and diffuse professional responsibility. These failure modes recur across electronic health records, decision support tools, registries, scheduling systems, and AI-enabled platforms. As part of the Clinically-Grounded Systems (CGS) series, this paper complements earlier analyses of system emergence, human-centered logistics, and patient-engaged governance by explaining why digital systems predictably fail when these conditions are absent. The paper is intended for clinicians, health system leaders, designers, and policymakers concerned with the safe and sustainable digitalisation of healthcare.

Keywords

Human-centered design, Patient safety, Health information systems, Sociotechnical systems, Professional autonomy, Clinical workflows, Clinical decision support, Cognitive workload, System failure modes, Healthcare digitalization

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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