Journal Article Annotations
2016, 3rd Quarter


Annotation by Christina Scully, MD
October 2016


Joy M, Clement T, Sisti D: The ethics of behavioral health information technology: frequent flyer icons and implicit bias
JAMA. Published online September 8, 2016

This article notes the implicit bias associated with electronic medical record iconography (a color coded airplane in this scenario) to depict a subpopulation of medical care utilizers, colloquially labeled “frequent flyers.”  Such icons may reinforce disrespectful terminology and negative assumptions, and bias clinical interactions, potentially placing patients at increased risk of poor outcomes.

Patients with mental illness and addiction are more likely to garner “frequent flyer” labels, thereby amplifying the negative effect of stigma that they already face in the healthcare setting.

Algorithms designed to identify patients with specific clinical challenges should be carefully designed to encourage ethical behavior and respectful clinical interactions.