Yearb Med Inform 2009; 18(01): 48-58
DOI: 10.1055/s-0038-1638638
Original Article
Georg Thieme Verlag KG Stuttgart

Current Challenges and Opportunities for Better Integration of Human Factors Research with Development of Clinical Information Systems

J. J. Saleem
1   Veterans Affairs Health Services Research & Development Center on Implementing Evidence-Based Practice, Indianapolis, IN, USA
2   Indiana University Center for Health Services & Outcomes Research, Indianapolis, IN, USA
3   Regenstrief Institute, Indianapolis, IN, USA
4   Department of Electrical and Computer Engineering, IUPUI, Indianapolis, IN, USA
,
A. L. Russ
1   Veterans Affairs Health Services Research & Development Center on Implementing Evidence-Based Practice, Indianapolis, IN, USA
2   Indiana University Center for Health Services & Outcomes Research, Indianapolis, IN, USA
,
P. Sanderson
5   The University of Queensland and National ICT Australia, St Lucia, QLD, Australia
,
T. R. Johnson
6   The University of Texas School of Health Information Sciences, Houston, TX, USA
,
J. Zhang
6   The University of Texas School of Health Information Sciences, Houston, TX, USA
,
D. F. Sittig
6   The University of Texas School of Health Information Sciences, Houston, TX, USA
7   UT – Memorial Hermann Center for Healthcare Quality & Safety, Houston, TX, USA
› Author Affiliations
Further Information

Correspondence to

Dean F. Sittig
UT-Memorial Hermann Center for Healthcare Quality and Safety 6410 Fannin St. UTPB 1100.43
Houston, TX 77030
USA
Phone: +1 713 500 7977   
Fax: +1 713 500 0766   

Publication History

Publication Date:
07 March 2018 (online)

 

Summary

Objectives Clinical information system (CIS) developers and implementers have begun to look to other scientific disciplines for new methods, tools, and techniques to help them better understand clinicians and their organizational structures, clinical work environments, capabilities of clinical information and communications technology, and the way these structures and processes interact. The goal of this article is to help CIS researchers, developers, implementers, and evaluators better understand the methods, tools, techniques, and literature of the field of human factors.

Methods We developed a framework that explains how six key human factors topics relate to the design, implementation, and evaluation of CISs.

Results Using this framework we discuss the following six topics: 1) informatics and patient safety; 2) user interface design and evaluation; 3) workflow and task analysis; 4) clinical decision making and decision support; 5) distributed cognition; and 6) mental workload and situation awareness.

Conclusions Integrating the methods, tools, and lessons learned from each of these six areas of human factors research early in CIS design and incorporating them iteratively during development can improve user performance, user satisfaction, and integration into clinical workflow. Ultimately, this approach will improve clinical information systems and healthcare delivery.


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Correspondence to

Dean F. Sittig
UT-Memorial Hermann Center for Healthcare Quality and Safety 6410 Fannin St. UTPB 1100.43
Houston, TX 77030
USA
Phone: +1 713 500 7977   
Fax: +1 713 500 0766   

  • References

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  • 2 Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE. et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA 2005; 293 (10) 1197-203.
  • 3 Congressional Budget Office: Evidence on the Costs and Benefits of Health Information Technology. May 2008 Available at: http://www.cbo.gov/ftpdocs/ 91xx/doc9168/05-20-HealthIT.pdf
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  • 5 Cochran GL, Jones KJ, Brockman J, Skinner A, Hicks RW. Errors prevented by and associated with bar-code medication administration systems. Jt Comm J Qual Patient Saf 2007; May; 33 (05) 293-301 245
  • 6 Morriss Jr FH. Effectiveness of a Barcode Medication Administration System in Reducing Preventable Adverse Drug Events in a Neonatal Intensive Care Unit: A Prospective Cohort Study. 2008
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  • 8 Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc 2004; MarApr; 11 (02) 104-12.
  • 9 Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003; 348 (25) 2526-34.
  • 10 Campbell EM, Sittig DF, Ash JS, Guappone KP, Dykstra RH. Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc 2006; 13 (05) 547-56.
  • 11 Weiner JP, Kfuri T, Chan K, Fowles JB. “eIatrogenesis”: the most critical unintended consequence of CPOE and other HIT. J Am Med Inform Assoc 2007; 14 (03) 387-88.
  • 12 Zhang J, Patel VL, Johnson TR, Shortliffe EH. A cognitive taxonomy of medical errors. J Biomed Inform 2004; 37 (03) 193-204.
  • 13 Horsky J, Kuperman GJ, Patel VL. Comprehensive analysis of a medication dosing error related to CPOE. J Am Med Inform Assoc 2005; 12 (04) 377-82.
  • 14 Hammond KW, Helbig ST, Benson CC, BrathwaiteSketoe BM. Are electronic medical records trustworthy? Observations on copying, pasting and duplication. AMIA Annu Symp Proc 2003; 269-73.
  • 15 Hartzband P, Groopman J. Off the record—avoiding the pitfalls of going electronic. N Engl J Med 2008; 358 (16) 1656-8.
  • 16 Weir CR, Hurdle JF, Felgar MA, Hoffman JM, Roth B, Nebeker JR. Direct text entry in electronic progress notes. An evaluation of input errors. Methods Inf Med 2003; 42 (01) 61-7.
  • 17 Glassman PA, Belperio P, Simon B, Lanto A, Lee M. Exposure to automated drug alerts over time: effects on clinicians’ knowledge and perceptions. of drug safety alerts in computerized physician order entry. J Am Med Inform Assoc 2006; 13 (02) 138-47.
  • 18 van der Sijs H, Aarts J, Vulto A, Berg M. Overriding of drug safety alerts in computerized physician order entry. J Am Med Inform Assoc 2006; 13 (02) 138-47.
  • 19 Cook RI, Woods DD. Implications of automation surprises in aviation for the future of total intravenous anesthesia (TIVA). J Clin Anesth 1996; 08 (03) 29S-37S.
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