Healthcare information systems: the cognitive challenge

Lintern, Gavan; Motavalli, Al

doi:10.1186/s12911-018-0584-z

Cited by 24 publications

(16 citation statements)

References 36 publications

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“…It is notable that different health care environments have different demands on EHRs, and thus different workflow can either be supported or distracted by EHRs. In order to support the complex cognitive workflows of health care environments, supporting technology must be designed to adapt the demands of the work and the cognitive strategies employed by health care practitioners [ 43 ]. Primary health care needs for an EHR are very different from hospital needs [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians

Vainiomäki

Heponiemi

Vänskä

et al. 2020

IJERPH

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Electronic health records (EHRs) have an impact on physicians’ well-being and stress levels. We studied physicians’ experiences with EHRs and their experienced time pressure and self-rated stress by an electronic questionnaire sent to Finnish physicians aged under 65 in 2017. Our sample was 2980 physicians working in the public sector, health care centers (35.5%) or hospitals (64.5%). Experienced technical problems were positively associated with experienced time pressure, whereas user-friendliness of the EHRs was negatively associated with experienced time pressure. Low perceived support for internal cooperation was associated with high levels of time pressure in hospitals. Those experiencing high levels of technical problems were 1.3 times more likely to experience stress compared to those experiencing low levels of technical problems. Better user-friendliness of the EHRs was associated with lower levels of self-rated stress. In both working environments but more strongly in primary health care, technical problems were associated with self-rated stress. Technical problems and user-friendliness of EHRs are the main factors associated with time pressure and self-rated stress. Health care environments differ in the nature of workflow having different demands on the EHRs. Developing EHR systems should consider the special needs of different environments and workflows, enabling better work well-being amongst physicians.

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Section: Discussionmentioning

confidence: 99%

Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians

Vainiomäki

Heponiemi

Vänskä

et al. 2020

IJERPH

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“…While we did identify eight articles on SDOH-EHR stakeholder engagement, they almost exclusively engaged healthcare and social services staff, despite “the maxim ‘Nothing about me without me’ … used to summarise the principles of patient-centered care and shared decision-making”. [ 60 ] While it is encouraging to see provider engagement reported in our study articles, according to Lintern and Motavalli [ 61 ], all too often, computerised health applications are designed by software engineers with little input even from providers experienced in day-to-day healthcare provision. The lack of user input in the design of systems to capture data has resulted in workflow inefficiencies, degraded customer service, and increased safety risks.…”

Section: Discussionmentioning

confidence: 83%

“Engaging stakeholders in integrating social determinants of health into electronic health records: a scoping review”

Wark

Cheung

Wolter

et al. 2021

International Journal of Circumpolar Health

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Social, environmental, and behavioural factors impact human health. Integrating these social determinants of health (SDOH) into electronic health records (EHR) may improve individual and population health. But how these data are collected and their use in clinical settings remain unclear. We reviewed efforts to integrate SDOH into EHR in the U.S. and Canada, especially how this implementation serves Indigenous peoples. We followed an established scoping review process, performing iterative keyword searches in subject-appropriate databases, reviewing identified works' bibliographies, and soliciting recommendations from subject-matter experts. We reviewed 20 articles from an initial set of 2,459. Most discussed multiple SDOH indicator standards, with the National Academy of Medicine's (NAM) the most frequently cited (n = 10). Common SDOH domains were demographics, economics, education, environment, housing, psychosocial factors, and health behaviours. Twelve articles discussed project acceptability and feasibility; eight mentioned stakeholder engagement (none specifically discussed engaging ethnic or social minorities); and six adapted SDOH measures to local cultures. Linking SDOH data to EHR as related to Indigenous communities warrants further exploration, especially how to best align cultural strengths and community expectations with clinical priorities. Integrating SDOH data into EHR appears feasible and acceptable and may improve patient care, patientprovider relationships, and health outcomes.

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“…Instead, healthcare technology must be designed sensitively, in a way that mirrors the cognitive processes of its users with real-world clinical benefit as the ultimate goal. 16 It is believed that existing technology has the potential to be optimised through sharing of creative and innovative best-practice examples.…”

Section: Discussionmentioning

confidence: 99%

What is the role of technology in improving patient safety? A French, German and UK healthcare professional perspective

Astier¹,

Carlet

Hoppe-Tichy

et al. 2020

Journal of Patient Safety and Risk Management

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Patient safety in hospitals can be compromised by preventable adverse events (AE). Among the preventable AEs, hospital-acquired infections (HAIs) are one of the most burdensome, contributing to not only poorer patient outcomes but institutional burden through direct financial losses and increased patient length of stay. Technological innovations can enhance patient safety by automating tasks, introducing medication alerts, clinical reminders, improved diagnostic and consultation reports, facilitating information sharing, improving clinical decision-making, intercepting potential errors, reducing variation in practice, and managing workforce shortages as well as making complete patient data available. A multidisciplinary working group from three European countries was convened to discuss how to optimise the use of technology to reduce preventable AEs in acute care hospitals. The working group identified examples where they felt there were opportunities to streamline patient pathways, including antimicrobial stewardship, point of care testing, microbiology test reporting to streamline time from sample-taking to clinical decision and mobile automated dispensing systems, which can reduce the burden on overworked staff. The working group also discussed key factors that were critical to ensuring different stakeholders, both within and outside the hospital, could meaningfully contribute to improving patient safety. They agreed that technological approaches and advances would have limited impact without meaningful cultural changes at all levels of healthcare infrastructure to implement the benefits offered by current or future technologies.

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Healthcare information systems: the cognitive challenge

Cited by 24 publications

References 36 publications

Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians

Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians

“Engaging stakeholders in integrating social determinants of health into electronic health records: a scoping review”

What is the role of technology in improving patient safety? A French, German and UK healthcare professional perspective

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