Cognitive performance-altering effects of electronic medical records: an application of the human factors paradigm for patient safety
- 25 March 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Cognition, Technology & Work
- Vol. 13 (1), 11-29
- https://doi.org/10.1007/s10111-010-0141-8
Abstract
According to the human factors paradigm for patient safety, health care work systems and innovations such as electronic medical records do not have direct effects on patient safety. Instead, their effects are contingent on how the clinical work system, whether computerized or not, shapes health care providers’ performance of cognitive work processes. An application of the human factors paradigm to interview data from two hospitals in the Midwest United States yielded numerous examples of the performance-altering effects of electronic medical records, electronic clinical documentation, and computerized provider order entry. Findings describe both improvements and decrements in the ease and quality of cognitive performance, both for interviewed clinicians and for their colleagues and patients. Changes in cognitive performance appear to have desirable and undesirable implications for patient safety as well as for quality of care and other important outcomes. Cognitive performance can also be traced to interactions between work system elements, including new technology, allowing for the discovery of problems with “fit” to be addressed through design interventions.Keywords
This publication has 86 references indexed in Scilit:
- The Technology Acceptance Model: Its past and its future in health careJournal of Biomedical Informatics, 2010
- Physicians’ beliefs about using EMR and CPOE: In pursuit of a contextualized understanding of health IT use behaviorInternational Journal of Medical Informatics, 2010
- The unintended consequences of computerized provider order entry: Findings from a mixed methods explorationInternational Journal of Medical Informatics, 2009
- Health Care and the American Recovery and Reinvestment ActThe New England Journal of Medicine, 2009
- A qualitative study of the implementation of a bioinformatics tool in a biological research laboratoryInternational Journal of Medical Informatics, 2007
- A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional: Figure 1BMJ Quality & Safety, 2006
- Work system design for patient safety: the SEIPS modelMaterials, 2006
- Types of Unintended Consequences Related to Computerized Provider Order EntryJournal of the American Medical Informatics Association, 2006
- Qualitative research in health care: Assessing quality in qualitative researchBMJ, 2000
- The theory of planned behaviorOrganizational Behavior and Human Decision Processes, 1991