Impact of a computer-based patient record system on data collection, knowledge organization, and reasoning

Area of Science:

• Cognitive science
• Health informatics
• Human-computer interaction

Background:

• Computer-based patient record systems act as cognitive artifacts.
• These systems influence healthcare professionals' knowledge acquisition, organization, and reasoning.

Purpose of the Study:

• To evaluate the cognitive effects of computer-based patient record systems on healthcare professionals.
• To understand how these systems shape information processing and clinical reasoning.

Main Methods:

• Comparative analysis of information organization in paper-based versus computer-based patient records.
• Observation and video recording of doctor-patient-computer interactions.
• Qualitative interviews and automatic logging of physician interactions with computer-based records.

Main Results:

• Physicians' information gathering and reasoning strategies changed with computer-based record use.
• Paper records used a narrative structure, while computer-based records organized information into discrete items.
• The structure of computer-based patient record systems influenced doctor-patient dialogue and data gathering.

Conclusions:

• Technological systems profoundly impact cognitive behavior in healthcare settings.
• Further research is needed to explore the reciprocal effects of cognition on technology design.