Why Medical Informatics (still) Needs Cognitive and Social Sciences

Summary

Objectives: To summarize current excellent medical informatics research in the field of human factors and organizational issues.

Methods: Using PubMed, a total of 3,024 papers were selected from 17 journals. The papers were evaluated on the basis of their title, keywords, and abstract, using several exclusion and inclusion criteria. 15 preselected papers were carefully evaluated by six referees using a standard evaluation grid.

Results: Six best papers were selected exemplifying the central role cognitive and social sciences can play in medical informatics research. Among other contributions, those studies: (i) make use of the distributed cognition paradigm to model and understand clinical care situations; (ii) take into account organizational issues to analyse the impact of HIT on information exchange and coordination processes; (iii) illustrate how models and empirical data from cognitive psychology can be used in medical informatics; and (iv) highlight the need of qualitative studies to analyze the unexpected side effects of HIT on cognitive and work processes.

Conclusion: The selected papers demonstrate that paradigms, methodologies, models, and results from cognitive and social sciences can help to bridge the gap between HIT and end users, and contribute to limit adoption failures that are reported regularly.

Keywords

Medical informatics - International Medical Informatics Association - human factors - organizational issues - cognitive sciences - social sciences

 

• References

• 1 Berg M, Toussaint T. The mantra of modeling and the forgotten powers of paper: a sociotechnical view on the development of process-oriented ICT in health care. Int J Med Inform 2003; 69: 223-34.
• 2 Berg M. Patient care information systems and health care work: a sociotechnical approach. Int J Med Inform 1999; 55 (2) 87-101.
• 3 Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inform 2001; 64 (2) 143-56.
• 4 Park SY, Pine K, Chen Y. Local-universality: designing EMR to support localized informal documentation practices. Proceedings of the 2013 conference on Computer supported cooperative work. ACM; 2013. p. 55-66.
• 5 Horsky J, Zhang J, Patel VL. To err is not entirely human: complex technology and user cognition. J Biomed Inform 2005; 38 (4) 264-6.
• 6 Karsh BT, Weinger MB, Abbott PA, Wears RL. Health information technology: fallacies and sober realities. JAm Med Inform Assoc 2010; 17 (6) 617-23.
• 7 Lau F. Extending the Infoway Benefits Evaluation framework for health information systems. Stud Health Technol Inform 2009; 143: 406-13.
• 8 Patel VL, Kaufman DR. Medical informatics and the science of cognition. J Am Med Inform Assoc 1998; 5 (6) 493-502.
• 9 Garfinkel H. Studies in ethnomethodology. NJ: Englewood Cliffs; 1967
• 10 International Medical Informatics Association (IMIA) website. Presentation of the Human Factors Engineering for Healthcare Informatics Working Group. http://www.imia-medinfo.org/new2/node/142
• 11 Heeks R. Information systems and developing countries: Failure, success, and local improvisations. The Information Society 2002; 18 (2) 101-12.
• 12 Heeks R. Health information systems: Failure. success and improvisation. Int J Med Inform 2006; 75 (2) 125-37.
• 13 Wears RL, Cook RI, Perry SJ. Automation, interaction, complexity, and failure: A case study. Reliability Engineering & System Safety 2006; 91 (12) 1494-501.
• 14 Black AD, Car J, Pagliari C, Anandan C, Cresswell K. et al. The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med 2011; 8 (1) e1000387.
• 15 Kuziemsky C, Jewers H, Appleby B, Foshay N, Maccaull W, Miller K. et al. Information technology and hospice palliative care: social, cultural, ethical and technical implications in a rural setting. Inform Health Soc Care 2011; 37 (1) 37-50.
• 16 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 (5) 547-56.
• 17 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; 11 (2) 104-12.
• 18 Whitten P, Holtz B, Meyer E, Nazione S. Telehos-pice: reasons for slow adoption in home hospice are. J Telemed Telecare 2009; 15 (4) 187-90.
• 19 Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care. An interactive sociotechnical analysis. J Am Med Inform Assoc 2007; 14 (5) 542-9.
• 20 Lluch M. Healthcare professionals' organisational barriers to health information technologies. A literature review. Int J Med Inform 2001; 80 (12) 849-62.
• 21 European Union's Seventh Framework Programme for Research (FP7), ICT Challenge 5: ICT for Health, Ageing Well, Inclusion and Governance. http://cordis.europa.eu/fp7/ict/programme/challenge5_en.html
• 22 Hutchins E. How a cockpit remembers its speeds. Cogn Sci 1995; 19 (3) 265-88.
• 23 Hollan J, Hutchins E, Kirsh D. Distributed cognition: toward a new foundation for human-computer interaction research. ACM Trans Comput Hum Interact 2000; 7 (2) 174-96.
• 24 Zhang J, Patel VL. Distributed cognition, representation, and affordance. Pragmatics& Cognition 2006; 14 (2) 333-41.
• 25 Norman DA. Cognitive artifacts. Department of Cognitive Science, University of California, San Diego; 1990
• 26 Kirsh D. The intelligent use of space. Artif Intell 1995; 73 (1) 31-68.
• 27 Lave J. Cognition in practice: Mind, mathematics and culture in everyday life. Cambridge Univer-sity Press: 1988
• 28 Gibson JJ. The ecological approach to visual perception. Psychology Press; 1986
• 29 Varela FJ, Thompson ET, Rosch E. The embodied mind: Cognitive science and human experience. MIT press; 1991
• 30 Lakoff G, Johnson M. Philosophy in the flesh: The embodied mind and its challenge to western thought. Basic Books (AZ). 1999
• 31 Clark A, Chalmers D. The extended mind. analysis 1998; 58 (1) 7-19.
• 32 Schraagen JM, Verhoeven F. Methods for studying medical device technology and practitioner cognition: The case of user-interface issues with infusion pumps. J Biomed Inform 2013; 46 (1) 181-95.
• 33 Norman DA. Things that make us smart: Defending human attributes in the age of the machine. Basic Books (AZ). 1993
• 34 Syed S, Paul JE, Hueftlein M, Kampf M, McLean RF. Morphine overdose from error propagation on an acute pain service. Can J Anesth 2006; 53 (6) 586-90.
• 35 Tariq A, Georgiou A, Westbrook J. Medication errors in residential aged care facilities: A distributed cognition analysis of the information exchange process. Int J Med Inform 2013; May 82 (5) 299-312.
• 36 Pelayo S, Anceaux F, Rogalski J, Elkin P, Beuscart-Zephir MC. A comparison of the impact of CPOE implementation and organizational determinants on doctor-nurse communications and cooperation. Int J Med Inform. 2012 Sep.
• 37 Djulbegovic B, Hozo I, Beckstead J, Tsalatsanis A, Pauker S. Dual processing model of medical decision-making. BMC Med Inform Decision Mak 2012; 12 (1) 94.
• 38 Mukherjee K. A dual system model of preferences under risk. Psychol Rev 2010; 117 (1) 243-55.
• 39 Kahneman D. Maps of bounded rationality: Psychology for behavioral economics. Am Econ Rev 2003; 93 (5) 1449-75.
• 40 Li SY, Magrabi F, Coiera E. (2012). A systematic review of the psychological literature on interruption and its patient safety implications. J Am Med Inform Assoc 2012; 19 (1) 6-12.
• 41 Park SY, Lee SY, Chen Y. The effects of EMR deployment on doctors' work practices: A qualitative study in the emergency department of a teaching hospital. Int J Med Inform 2012; 81 (3) 204-17.
• 42 Zhou X, Ackerman MS, Zheng K. I just do not know why it is gone: maintaining informal information use in patient care. Proceedings of CHI 2009; 2009; p. 2061-70.
• 43 Goody J. The domestication of the savage mind. Cambridge [Eng.]. New York: Cambridge University Press; 1977
• 44 Schuemie MJ, Talmon J, Moorman PW, Kors JA. Mapping the domain of medical informatics. Methods Inf Med 2009; 48 (1) 76.