Clinicians' Visual Attention During Suicide Screening Encounters: An Exploratory Eye-Tracking Study.

Area of Science:

• Clinical Informatics
• Human-Computer Interaction
• Cognitive Science

Background:

• Eye tracking is a validated method for assessing visual attention and cognitive load.
• Electronic Health Records (EHRs) are integral to modern primary care but can create dual demands for clinicians.
• Understanding how clinicians interact with EHRs during patient encounters is crucial for optimizing workflows.

Purpose of the Study:

• To investigate how primary care providers' visual attention is allocated between patient communication and EHR navigation.
• To examine the impact of EHR-embedded suicide risk screening tools on clinical decision-making and encounter flow.
• To analyze the interplay between eye movements and verbalized thought processes during simulated patient visits.

Main Methods:

• Utilized wearable eye tracking to capture visual information processing behavior.
• Employed a retrospective think-aloud protocol to gather qualitative insights into clinicians' cognitive processes.
• Conducted simulated patient visits incorporating an EHR-embedded suicide risk assessment tool (CAT-MH®).

Main Results:

• Eye-movement data indicated significant visual attention directed towards the EHR interface.
• Clinicians frequently navigated multiple EHR sections to verify suicide risk indicators.
• Retrospective data revealed a tendency to postpone suicide-related discussions until information verification was complete.

Conclusions:

• EHR design and embedded tools can significantly influence clinical attention distribution and communication timing.
• The integration of screening tools within EHRs introduces information-processing demands that affect encounter dynamics.
• Further research is needed to optimize EHR usability and minimize disruptions to patient-clinician communication.