Associations between smart infusion pump-electronic health record interoperability and healthcare outcomes: A systematic review.

Azizeh Sowan; Matt Hayward; Annette Holzknecht; Mona Mourad; Carla Rodschat; Ana Vera

doi:10.1016/j.iccn.2026.104475

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Associations between smart infusion pump-electronic health record interoperability and healthcare outcomes: A systematic review.

Azizeh Sowan·Matt Hayward·Annette Holzknecht·Mona Mourad·Carla Rodschat·Ana Vera

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Abstract

OBJECTIVE: This study synthesized available evidence on the associations between smart infusion pump-electronic health record (EHR) interoperability and healthcare outcomes. METHODS: A systematic review of PubMed, CINAHL, Embase, and Scopus databases identified 901 records, which were imported into Rayyan® for duplicate removal, independent screening by three reviewers, and resolution of discrepancies. Eligible studies were peer-reviewed, data-driven, and reported associations between smart infusion pump-EHR interoperability and healthcare outcomes. Studies focused solely on technical validation or interoperability prototypes were excluded. A backward citation search identified additional studies. Two reviewers independently extracted and cross-validated study characteristics using standardized templates. Methodological quality was assessed with the Joanna Briggs Institute Critical Appraisal Tools. RESULTS: Twenty records of 14 full-text studies and 6 conference proceedings were included. Most records reported positive associations between smart infusion pump-EHR interoperability and outcomes related to safety (e.g., medication administration errors, safety-reported events, pump alerts, and compliance with interoperability and drug library), operational efficiency (e.g., programming and documentation time and technical issues), financial performance (e.g., charges captured, and cost avoided), and user experience domains. Most studies used observational designs, reflecting real-world interoperability implementations, where controlling confounding factors is challenging. Limited reporting of baseline characteristics, pump type, and sample sizes limited comparability across studies. CONCLUSIONS: Smart infusion pump-EHR interoperability was associated with improvements in patient safety, efficiency, charge capture, and user experience, with variable findings across studies. Future research should use rigorous methodologies and standardized measures, examine relationships across outcome domains, assess limitations of pump-EHR interoperability, and evaluate underexplored outcomes, including team communication, cognitive workload, and AI-enabled pumps. IMPLICATIONS FOR CLINICAL PRACTICE: Interoperability should be viewed as a component of a broader sociotechnical system, in which technology, user, workflow, clinical content, and organizational practices collectively determine overall effectiveness.

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Humans Electronic Health Records Infusion Pumps Outcome Assessment, Health Care Health Information Interoperability Digital Health Efficiency Electronic health record Healthcare cost Infusion pump Interoperability Intravenous Medication errors Patient safety Workflow Journal Article Systematic Review Review

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Azizeh Sowan, Matt Hayward, Annette Holzknecht, Mona Mourad, Carla Rodschat, Ana Vera. 2026-07-22. Associations between smart infusion pump-electronic health record interoperability and healthcare outcomes: A systematic review.. https://doi.org/10.1016/j.iccn.2026.104475

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Digital Health subject Efficiency subject Electronic Health Records subject Electronic health record subject Health Information Interoperability subject Healthcare cost subject Humans subject Infusion Pumps subject Infusion pump subject Interoperability subject Intravenous subject Journal Article subject Journal Article; Systematic Review; Review resource Medication errors subject Outcome Assessment, Health Care subject Patient Safety subject

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