AHRQ-Funded Research Supports Clinicians’ Work
Research funded by AHRQ aims to support clinicians and other healthcare professionals in providing health services. The projects highlighted below share the goal of improving the experience of health professionals who use health IT. The featured researchers investigated how health professionals interact with technology and how technology can be optimally integrated in tasks undertaken on a daily basis.
Human Factors Design
Human Factors Design is the study of human behavior, the environment, and technology with the goals of reducing human error and increasing productivity. In the context of health IT, human factors design focuses on healthcare professionals’ abilities and limitations when interacting with computers or other technologies such as EHRs. Given the increasing role and complexity of technology in healthcare, AHRQ funded the following researchers to study the impact of technology on clinicians, and to test strategies to improve clinicians’ experiences using technology in the healthcare setting.
Through focus groups and a survey of providers, Dr. Philip Kroth found that use of health information communication technology (HICT) contributes to work-related stress, burnout, and lack of job satisfaction. The challenges of HICT include excessive data entry, lack of work-life balance, and poor posture and physical pain from using HICT. Good self-care, exercise, and resiliency training were found to be helpful coping strategies. Dr. Kroth recommended efforts to reduce information overload and changing policy so that notes focus on documenting clinical care, rather than supporting billing.
Dr. Jason Saleem tested a redesigned clinic exam room that included a mobile computer station and wall-mounted monitor for ease of repositioning. This room configuration led to more time sharing the screen with patients, reduced workload, and gave clinicians greater situational awareness.
Dr. Foster Goss developed a natural language processing (NLP) EHR search tool that automatically identifies and ranks relevant clinical information based on a patient’s presenting complaint within the emergency department (ED) setting.
To support clinician productivity, Dr. Genevieve Melton-Meaux, employed NLP to identify and visually distinguish new versus redundant information in clinical notes. Findings will be used to inform future EHR design considerations to improve usability and decrease clinician cognitive burden.
Clinical Work Flow
Clinical Work Flow is a defined series of steps taken by a clinician to provide care or treatment to a patient. With deliberate and structured planning, testing, and implementation processes, health IT can support clinical workflow and enhance clinicians’ efficiency. The following two AHRQ-funded researchers investigated the impact of health IT on clinical workflow.
Dr. Hardeep Singh studied how clinicians complete tasks related to laboratory test results to understand the reasons for delayed diagnoses resulting from failure to follow up on test results. Dr. Singh found that common barriers include poorly designed communication interfaces between the EHR and diagnostic services and usability challenges with the EHR. He recommended using dedicated personnel to follow up on lab results and implementing EHR designs to facilitate followup of laboratory test results.
Dr. Scott Ryan Levin tested E-triage, a machine-learning algorithm, to predict the risk of adverse outcomes in the ED. E-triage improved identification of low-risk patients, allowing providers to focus their time and attention on patients with greater risk. Additionally, the algorithm reduced the time to decide whether to admit a patient by 58 minutes and the time to see a clinician by 10 minutes.