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Cognitive workload reduction in hospital information systems : Decision support for order set optimization.

Daniel Gartner1, Yiye Zhang2, Rema Padman3

  • 1School of Mathematics, Cardiff University, Cardiff, Wales, UK. gartnerd@cardiff.ac.uk.

Health Care Management Science
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PubMed
Summary

Optimizing hospital order sets can significantly reduce physician cognitive workload. This study introduces a mathematical model and heuristic approach, demonstrating potential workload reductions of approximately 20% for improved patient care.

Keywords:
Analytical modelingHealth informatics/health information systems/medical ISHealthcare information systemsHeuristicsOptimization

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Area of Science:

  • Health Informatics
  • Operations Research
  • Clinical Decision Support

Background:

  • Hospital information systems utilize order sets to streamline clinical workflows.
  • Physician cognitive workload and patient safety are key concerns in healthcare delivery.
  • Current order set configurations may not be optimally designed for efficiency.

Purpose of the Study:

  • To develop a mathematical programming model to minimize cognitive workload associated with hospital order sets.
  • To create exact and heuristic solution procedures for optimizing order set design.
  • To provide a decision support system for analyzing and improving order set configurations.

Main Methods:

  • Development of a mathematical programming model for order set optimization.
  • Implementation of exact and heuristic solution procedures.
  • Case study analysis using asthma patient order data from a pediatric hospital.
  • Comparison of proposed solutions against the current hospital order set configuration.

Main Results:

  • A valid lower bound for order set size was established.
  • Time interval decomposition and K-means clustering reduced computation times.
  • Mathematical programming reduced cognitive workload by ~20.2% with 1-5 order sets.
  • Heuristic approach reduced cognitive workload by ~19.5% with 1-5 order sets.

Conclusions:

  • Optimized order sets can substantially decrease physician cognitive workload.
  • Mathematical modeling and heuristic approaches offer effective solutions for order set design.
  • A decision support system can aid practitioners in evaluating and implementing optimized order sets.