How Do Clinical Information Systems Affect the Cognitive Demands of General Practitioners?: Usability Study with a Focus on Cognitive Workload.
How Do Clinical Information Systems Affect the Cognitive Demands of General Practitioners?: Usability Study with a Focus on Cognitive Workload.
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DOI：
10.14236/jhi.v22i4.85
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发表时间：
2015-11-20
影响因子：
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通讯作者：
Potts, Henry Ww
中科院分区：
文献类型：
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作者：
Ariza, Ferran;Kalra, Dipak;Potts, Henry Ww
背景：国家卫生服务体系中的临床信息系统不需要符合任何明确的可用性要求。可用性差会增加临床医生的脑力负担并导致疲劳，增加错误率并影响患者的整体安全。脑力负荷可用作可用性的衡量标准。 目的：评估全科医生 (GP) 使用其系统所经历的主观认知负荷。为了提高用户、设计师、开发人员和政策制定者对系统设计中可用性重要性的认识。方法：我们使用了 NASA 任务负载指数的修改版本，适用于网络。我们在在线调查中开发了一组常见的临床场景和计算机任务。我们通过电子邮件将研究链接发送给英格兰的 199 个临床委托小组和 1,646 个全科医生诊所。 结果：67 名受访者完成了调查。受访者平均在全科诊所工作了 17 年，平均使用过 1.5 GP 计算机系统，并且平均使用当前系统的时间为 6.7 年。系统之间的脑力负荷分数没有差异。任务分数之间存在显着差异，但这些差异并不特定于特定系统。总分和任务得分与他们使用现有系统的经验长度有关。结论：有四项任务给全科医生带来了较高的脑力负担：“重复处方”、“查找事件”、“药物管理”和“概述记录”。 GP 系统的进一步可用性研究应集中在这些任务上。用户、政策制定者、设计者和开发者应该始终意识到可用性在系统设计中的重要性。这项研究增加了什么？英国当前的 GP 系统不需要遵守明确的可用性要求。可用性差会增加临床医生的脑力负担并导致错误。一些临床计算机任务比其他任务需要更多的认知工作量，在系统设计过程中应仔细考虑。全科医生在使用其系统执行常见临床任务时并未报告整体非常高水平的主观认知工作量。对 GP 系统的进一步可用性研究应重点关注产生较高认知工作量的任务。用户、政策制定者、设计者和开发者应该始终意识到可用性在系统设计中的重要性。
BACKGROUND: Clinical information systems in the National Health Service do not need to conform to any explicit usability requirements. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Mental workload can be used as a measure of usability.OBJECTIVE: To assess the subjective cognitive workload experienced by general practitioners (GPs) with their systems. To raise awareness of the importance of usability in system design among users, designers, developers and policymakers.METHOD: We used a modified version of the NASA Task Load Index, adapted for web. We developed a set of common clinical scenarios and computer tasks on an online survey. We emailed the study link to 199 clinical commissioning groups and 1,646 GP practices in England.RESULTS: Sixty-seven responders completed the survey. The respondents had spent an average of 17 years in general practice, had experience of using a mean of 1.5 GP computer systems and had used their current system for a mean time of 6.7 years. The mental workload score was not different among systems. There were significant differences among the task scores, but these differences were not specific to particular systems. The overall score and task scores were related to the length of experience with their present system.CONCLUSION: Four tasks imposed a higher mental workload on GPs: 'repeat prescribing', 'find episode', 'drug management' and 'overview records'. Further usability studies on GP systems should focus on these tasks. Users, policymakers, designers and developers should remain aware of the importance of usability in system design.What does this study add? Current GP systems in England do not need to conform to explicit usability requirements. Poor usability can increase the mental workload of clinicians and lead to errors. Some clinical computer tasks incur more cognitive workload than others and should be considered carefully during the design of a system. GPs did not report overall very high levels of subjective cognitive workload when undertaking common clinical tasks with their systems. Further usability studies on GP systems should focus on the tasks incurring higher cognitive workload. Users, policymakers, and designers and developers should remain aware of the importance of usability in system design.