Safer Design - Composable EHRs and Mechanisms for Safety

As the deployment of health information technology progresses, issues of usability and safety, including the possibility of technology-induced errors have come to the fore. Increased complexity of care delivery models and emergent conditions such as the Ebola scare in the US point to the difficulty of design that allows for human cognitive limits while meeting complex needs. We previously described a modular composable approach to health information systems, which gives the end-user some control of design and allows for creation of systems meeting myriad and varied needs. Here we discuss how the different drag/drop interaction paradigm has implications for health IT safety via several mechanisms. These include display fragmentation and the need to changeably prioritize information elements, interruptions, fit to tasks and contexts, and rapid changeability allowing low-cost readjustments when lack of fit is found.