Carlton Moore, MD, associate professor of medicine in the division of hospital medicine, contributed to a recent quality improvement study published in JAMA Network Open that considers how current interfaces for electronic health records (EHR) may be associated with excess cognitive workload and poor performance levels for physicians.
The study included residents and fellows from a large academic system, working in a simulated EHR environment from April 1, 2016, to December 23, 2016. Cognitive workload was quantified subjectively using the NASA-Task Load Index and physiology using blink rates. Performance was quantified according to the percentage of appropriately managed abnormal test results. The study consisted of 38 participants, with 20 participants allocated to the baseline HER and 18 allocated to the enhanced HER.
The baseline showed significantly poorer performance compared with the enhanced group, which appropriately managed 16% more abnormal tests results and demonstrated a statistically higher cognitive workload as quantified by blink rate. As a result, the study concluded basic system enhancements were associated with better physician cognitive workload and performance, suggesting next generation systems should remove non-value-added interactions to eliminate suboptimal workflows.