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Practical Methodology of Cognitive Tasks Within a Navigational Assessment
Published on: June 1, 2015
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A micro-analytic approach to understanding electronic health record navigation paths
Benjamin J Duncan1, David R Kaufman2, Lu Zheng1
1Biomedical Informatics, College of Health Solutions, Arizona State University, AZ, USA.
Journal of Biomedical Informatics
|September 16, 2020
Summary
Electronic health record (EHR) interface design significantly impacts clinician performance. Simplifying EHR navigation through interface changes can improve task efficiency and workflow for healthcare professionals.
Area of Science:
- Human-Computer Interaction
- Health Informatics
- Cognitive Science
Background:
- Clinician task performance is critically dependent on the efficiency of electronic health record (EHR) system interfaces.
- Navigational complexity within EHRs can impede workflow and potentially affect patient care.
Purpose of the Study:
- To propose and evaluate a navigational complexity framework for analyzing EHR interface differences.
- To assess the impact of EHR interface design on clinician task performance, specifically nurses performing medication administration record (MAR) tasks.
Main Methods:
- Employed expert-based methods: representational analysis, keystroke level modeling (KLM), and cognitive walkthrough.
- Conducted quantitative analysis of interactive behaviors using video-captured observations of nurses across three EHR systems.
- Studied MAR tasks during preoperative patient assessment.
Main Results:
- Characterized EHR navigation complexities through analysis of task steps, time spent, click counts, and screen transitions.
- Identified that single-screen EHR interfaces required less time (mean 101.5s) compared to multi-screen interfaces (176s, a 73% increase).
- Found that perceptual-motor activity, visual search, and memory load influenced navigational complexity and potentially nurses' performance.
Conclusions:
- Navigational complexity in EHR systems presents trade-offs in cognitive processes that can affect clinician performance.
- Minor, manageable adjustments in EHR interface design can lead to significant improvements in navigation, usability, and workflow.
- The proposed framework aids in understanding and mitigating EHR navigational challenges.
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