149 Impact of a Novel Electronic Health Records Design on Decision-making

Wednesday, March 20, 2013: 3:15 p.m. - 4:45 p.m.
Location: Room 401 (Washington State Convention Center)
Presentation Type: Oral Session
T.P. THYVALIKAKATH1, A. KYROS1, R. OLDHAM2, A. KUSHNIRUK3, and T. SCHLEYER1, 1Center for Dental Informatics, Dental Public Health, University of Pittsburgh, Pittsburgh, PA, 2Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, 3School of Health Information Science, University of Victoria, Victoria, BC, Canada
Objective: Poorly designed interfaces of Electronic Health Records have negatively affected clinicians' productivity and even compromised patient safety. In this study, a prototype (DMDp) designed based on clinicians' cognitive and information processes was comparatively evaluated against a major commercial dental EHR, (cEDR) to determine the users' perceptions on information organization, navigation and usability.

Method: A 'within subject design' was employed and a convenience sample of ten dental clinicians with in-depth experience of using cEDR participated. Participants reviewed videos that demonstrated three information management tasks performed by dentists during a patient visit in the two systems. They also interacted with the two systems.  Subsequently, a researcher interviewed them on information organization, navigation flow and usability of the two systems and administered a questionnaire for user interface satisfaction (QUIS). The interview transcripts were analyzed using thematic analysis. Descriptive statistics and paired t- tests were performed to detect statistically significant differences in the participants’ QUIS responses for two systems.

Result: All the participants perceived the navigation, information organization and usability of the DMDp to be better than the cEDR. They felt information is much better organized, shows all the relevant information in an intuitive manner and the navigation through the information follows a logical order that supports how a clinician thinks during a patient visit. In contrast, the participants perceived cEDR to have a steep learning curve and fragmented information presentation across multiple screens. As a result, they have to make extra effort to learn and remember the system’s information flow. With training and experience, the users do become proficient in using cEDR. The QUIS results showed statistically significant higher levels of satisfaction with the DMDp than with cEDR.

Conclusion: The results demonstrated the significance of applying cognitive engineering methods to inform better clinical systems design with potential to enhance the quality and safety of patient care.

This abstract is based on research that was funded entirely or partially by an outside source: KL2RR024154 grant from NIH/NCRR, 5K08DE018957 grant from NIH/ NIDCR and 2T15LM007059-26 from NIH/NLM.

Keywords: Decision-making, Dental Informatics, Effectiveness and Interfaces