Patel V L, Kannampallil T G
Vimla L. Patel, Center for Cognitive Studies, in Medicine and Public Health, The New York Academy of Medicine, 1216 5th Avenue, New York, NY, E-mail:
Yearb Med Inform. 2014 Aug 15;9(1):58-66. doi: 10.15265/IY-2014-0005.
Recent federal mandates and incentives have spurred the rapid growth, development and adoption of health information technology (HIT). While providing significant benefits for better data integration, organization, and availability, recent reports have raised questions regarding their potential to cause medication errors, decreased clinician performance, and lowered efficiency. The goal of this survey article is to (a) examine the theoretical and foundational models of human factors and ergonomics (HFE) that are being advocated for achieving patient safety and quality, and their use in the evaluation of healthcare systems; (b) and the potential for macroergonomic HFE approaches within the context of current research in biomedical informatics.
We reviewed literature (2007-2013) on the use of HFE approaches in healthcare settings, from databases such as Pubmed, CINAHL, and Cochran.
Based on the review, we discuss the systems-oriented models, their use in the evaluation of HIT, and examples of their use in the evaluation of EHR systems, clinical workflow processes, and medication errors. We also discuss the opportunities for better integrating HFE methods within biomedical informatics research and its potential advantages.
The use of HFE methods is still in its infancy - better integration of HFE within the design lifecycle, and quality improvement efforts can further the ability of informatics researchers to address the key concerns regarding the complexity in clinical settings and develop HIT solutions that are designed within the social fabric of the considered setting.
近期的联邦指令和激励措施推动了健康信息技术(HIT)的快速增长、发展和应用。虽然HIT在改善数据整合、组织和可用性方面带来了显著益处,但近期的报告对其可能导致用药错误、降低临床医生绩效和效率提出了质疑。这篇综述文章的目的是:(a)研究为实现患者安全和质量而倡导的人因工程学(HFE)的理论和基础模型,以及它们在医疗系统评估中的应用;(b)探讨在生物医学信息学当前研究背景下宏观人因工程学HFE方法的潜力。
我们检索了2007年至2013年期间发表在PubMed、CINAHL和Cochran等数据库中关于HFE方法在医疗环境中应用的文献。
基于该综述,我们讨论了面向系统的模型、它们在HIT评估中的应用,以及它们在电子健康记录(EHR)系统、临床工作流程和用药错误评估中的应用实例。我们还讨论了在生物医学信息学研究中更好地整合HFE方法的机会及其潜在优势。
HFE方法的应用仍处于起步阶段——在设计生命周期中更好地整合HFE以及质量改进工作,可以进一步提高信息学研究人员解决临床环境复杂性关键问题的能力,并开发出在特定社会环境中设计的HIT解决方案。