Parallel Assessment Tracks for Human-Centered Design (PATH): A Framework for Transitioning to a New Health Information Technology System

2021 ◽  
Vol 65 (1) ◽  
pp. 294-298
Author(s):  
Jason J. Saleem ◽  
Kyle Maddox ◽  
Jennifer Herout ◽  
Kurt Ruark
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
Large Scale ◽  
Comprehensive Evaluation ◽  
Customer Relationship ◽  
Human Factors Engineering ◽  
Human Centered Design ◽  
Legacy System

This practice-oriented paper presents a human-centered design (HCD) framework that we developed to perform a comprehensive evaluation of a new health information technology (HIT) system under development, intended to replace a legacy system. The Department of Veterans Affairs (VA) Veteran Crisis Line (VCL) program provides a vital service in crisis intervention and suicide prevention. VCL staff rely on a Customer Relationship Management (CRM) legacy system, Medora. VCL intended to replace Medora with Microsoft Dynamics 365 (D365) CRM system. Due to wide-spread criticism of D365, the VA Human Factors Engineering (HFE) team engaged in a multi-study, mixed-method HCD evaluation to investigate the legacy system and intended replacement in terms of ability to support VCL staff needs. The HCD framework we developed to perform this evaluation may be adapted for other large-scale HIT transitions and may provide human factors practitioners with guidance to make evidence-based decisions to support (or abandon) such transitions.

scholarly journals Human Factors and Usability for Health Information Technology: Old and New Challenges

2019 ◽  
Vol 28 (01) ◽  
pp. 071-077 ◽  
Author(s):  
Pascale Carayon ◽  
Peter Hoonakker
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care Professionals ◽  
Recent Literature ◽  
Health It ◽  
Human Centered Design ◽  
Usability Problems

Objectives: Despite national mandates, incentives, and other programs, the design of health information technology (IT) remains problematic and usability problems continue to be reported. This paper reviews recent literature on human factors and usability of health IT, with a specific focus on research aimed at applying human factors methods and principles to improve the actual design of health IT, its use, and associated patient and clinician outcomes. Methods: We reviewed recent literature on human factors and usability problems of health IT and research on human-centered design of health IT for clinicians and patients. Results: Studies continue to show usability problems of health IT experienced by multiple groups of health care professionals (e.g., physicians and nurses) as well as patients. Recent research shows that usability is influenced by both designers (e.g., IT vendors) and implementers in health care organizations, and that the application of human-centered design practices needs to be further improved and extended. We welcome emerging research on the design of health IT for teams as team-based care is increasingly implemented throughout health care. Conclusions: Progress in the application of human factors methods and principles to the design of health IT is occurring, with important information provided on their actual impact on care processes and patient outcomes. Future research should examine the work of health IT designers and implementers, which would help to develop strategies for further embedding human factors engineering in IT design processes.

scholarly journals Informatics and interaction: Applying human factors principles to optimize the design of clinical decision support for sepsis

2019 ◽  
Vol 26 (1) ◽  
pp. 642-651
Author(s):  
Laura Schubel ◽  
Danielle L Mosby ◽  
Joseph Blumenthal ◽  
Muge Capan ◽  
Ryan Arnold ◽  
...  
Keyword(s):  
Information Technology ◽  
Decision Support ◽  
Human Factors ◽  
Organ Failure ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision Support ◽  
Clinical Care ◽  
Clinical Decision ◽  
Wide Range

In caring for patients with sepsis, the current structure of electronic health record systems allows clinical providers access to raw patient data without imputation of its significance. There are a wide range of sepsis alerts in clinical care that act as clinical decision support tools to assist in early recognition of sepsis; however, there are serious shortcomings in existing health information technology for alerting providers in a meaningful way. Little work has been done to evaluate and assess existing alerts using implementation and process outcomes associated with health information technology displays, specifically evaluating clinician preference and performance. We developed graphical model displays of two popular sepsis scoring systems, quick Sepsis Related Organ Failure Assessment and Predisposition, Infection, Response, Organ Failure, using human factors principles grounded in user-centered and interaction design. Models will be evaluated in a larger research effort to optimize alert design to improve the collective awareness of high-risk populations and develop a relevant point-of-care clinical decision support system for sepsis.

scholarly journals A Staged Approach for Facilitating Joint End User, Vendor, and Multi-Disciplinary Subject Matter Expert Input to Health Information Technology Recommendations

2019 ◽  
Vol 8 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Ellen J. Bass ◽  
Carl Pankok ◽  
Yushi Yang ◽  
Sheryl Potashnik ◽  
Kathryn H. Bowles ◽  
...  
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Home Health Care ◽  
Systems Engineering ◽  
Subject Matter ◽  
Human Factors Engineering ◽  
Policies And Procedures ◽  
Staged Approach ◽  
Expert Input

Design of health information technology (HIT) that improves patient outcomes is an ongoing process. We propose a methodology that takes a human factors engineering approach to develop systems-engineering-style requirements and design recommendations for both HIT and aspects beyond the scope of the HIT itself (e.g., policies and procedures). Our approach includes: (1) data collection and analysis; (2) preliminary recommendations generation; (3) recommendation review by methodological and domain subject matter experts; (4) revised recommendation review by end users; (5) revised recommendation review by HIT vendors; and (6) final recommendation generation. We illustrate the methodology by presenting a case study focusing on home health care nurses using HIT during the home care admission process.

scholarly journals Are We There Yet? Human Factors Knowledge and Health Information Technology – the Challenges of Implementation and Impact

2017 ◽  
Vol 26 (01) ◽  
pp. 84-91 ◽  
Author(s):  
P. Turner ◽  
A. Kushniruk ◽  
C. Nohr
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
System Development ◽  
Evidence Base ◽  
Unintended Consequences ◽  
Active Involvement ◽  
Usability Problems ◽  
Development Life Cycle

Summary Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas. This selective rather than systematic review of recent HF research highlights these key challenges and reflects on their implications on the future impact of HF research on HIT. Results: Research provides evidence of continued poor design, implementation, and usability of HIT, as well as technology-induced errors and unintended consequences. The paper highlights support for: (i) strengthening the evidence base on the benefits of HF approaches; (ii) improving knowledge translation in the implementation of HF approaches during HIT design, implementation, and evaluation; (iii) increasing transparency, governance, and enforcement of HF best practices at all stages of the HIT system development life cycle. Discussion and Conclusion: HF and usability approaches are yet to become embedded as integral components of HIT development, implementation, and impact assessment. As HIT becomes ever-more pervasive including with patients as end-users, there is a need to expand our conceptualisation of the problems to be addressed and the suite of tactics and strategies to be used to calibrate our pro-active involvement in its improvement.

scholarly journals Human Factors and Health Information Technology: Current Challenges and Future Directions

2014 ◽  
Vol 23 (01) ◽  
pp. 58-66 ◽  
Author(s):  
T. G. Kannampallil ◽  
V. L. Patel
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
Medication Errors ◽  
Biomedical Informatics ◽  
Health Care Systems ◽  
Clinical Workflow ◽  
Federal Mandates ◽  
Care Systems

Summary Objectives: Recent federal mandates and incentives have spurred the rapid growth, development and adoption of health information technology (HIT). While providing significant benefits for better data integration, organization, and availability, recent reports have raised questions regarding their potential to cause medication errors, decreased clinician performance, and lowered efficiency. The goal of this survey article is to (a) examine the theoretical and foundational models of human factors and ergonomics (HFE) that are being advocated for achieving patient safety and quality, and their use in the evaluation of health-care systems; (b) and the potential for macroergonomic HFE approaches within the context of current research in biomedical informatics. Methods: We reviewed literature (2007-2013) on the use of HFE approaches in healthcare settings, from databases such as Pubmed, CINAHL, and Cochran. Results: Based on the review, we discuss the systems-oriented models, their use in the evaluation of HIT, and examples of their use in the evaluation of EHR systems, clinical workflow processes, and medication errors. We also discuss the opportunities for better integrating HFE methods within biomedical informatics research and its potential advantages. Conclusions: The use of HFE methods is still in its infancy - better integration of HFE within the design lifecycle, and quality improvement efforts can further the ability of informatics researchers to address the key concerns regarding the complexity in clinical settings and develop HIT solutions that are designed within the social fabric of the considered setting.

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