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Health Information Technology and the
Role of Cognition and Human Factors
Engineering
Vimla L. Patel, PhD, DSc, FRSC
Center for Cognitive Informatics and Decision Making
School of Biomedical Informatics
The University of Texas Health Science Center at Houston
[email protected]
Presented at the Symposium on Los retos de la era de la
información en nuestro país, Universidad Nacional Autónoma de
México (UNAM), Mexico City
March1-2, 2011
Institute of Medicine
Health Information Technology
• Computer technology has revolutionized
health care
• But HIT has not been without its challenges
• Human Factors: The science of
understanding the properties of human
capacity
• Human Factors Engineering: The
application of this understanding to the
design, development, and deployment of
systems and services
Current Status and Challenges
• Easy but selective access to patients’
discharge summaries, consultation
reports, and data such as X-rays or CT
Scans
• Challenge: Integrating information in
different formats (narrative text,
numerical, graphical) from various
clinical sources
• Challenge: Cognitive load increases
with integration of knowledge from
different sources
Current Status and Challenges
• Warnings are given for drug-drug interactions,
overdosing of medications, and any allergies.
This reduces medical hazards.
Challenge: Clinicians often ignore warnings and
reminders if they are too frequent or are viewed
as trivial
• Computer systems contain extensive clinical data
and display them in respond to user requests
Challenge: To be able to represent and display
relevant patient information in a way that can
used effectively and efficiently for health care
decisions (visualization)
Challenges and Solutions
Challenge: When information technology is
not implemented or not well integrated into
workflow, unnecessary tasks are performed
and errors are generated.
Solutions: Understanding of real world health
care practice.
Describe what clinicians do in their
workplaces (clinical workflow). What are
their daily tasks? Kinds of demands they
have on their memory, clinical problem
solving and decision making? How can
technology help to manage these demands?
Challenges and Solutions
• Health care is moving toward team work;
collaborations and communication
breakdowns are very common:
Development and use of computer-based
collaborative software becomes critical
• The healthcare system is complex, and
current methods of investigations do not
provide accurate data for informatics
related interventions:
Complexity of health care system will
require new ways of data collection and
monitoring
Resource Sharing Between Human
Minds and the Technology that
Supports Cognitive Work
Intellectual Partnership
• Distributed cognition
• Human-computer interaction analysis paradigm
• Knowledge resides
partly inPDA
the
environment
Intellectual Partnership
PDA

Coordinating internal (user’s mind) and
external (interface, environment) resources
Dealing with
Complexity and Surprises
RID Data Collection
Data Collection
•Radio Identification (RID) Tracking
RID technology is utilized to collect data only and not for
active intervention
Track clinicians using RID badges
Infer clinician interaction based on audio recording and
proximity
Simulation
•Use RID data and ethnographic observation data to develop
simulation
•Use RID data to validate simulation
Data Collection Strategy
Integrated Audio-Visual Data
Analysis Tool
Transfer of Technology:
International Studies
• Africa: Electronic watches
• Zimbabwe: Multimedia demonstration
• India: Cell phones
Lesson:
Must not introduce technology in any
society without understanding the
culture, cognition, and technology
need
Thank You
[email protected]
http://www.sahs.uth.tmc.edu/vpatel