Cognitive analysis of physicians' medication ordering activity.
Computerized Physician Order Entry (CPOE) addresses critical functions in healthcare systems. As the name clearly indicates, these systems focus on order entry. With regard to medication orders, such systems generally force physicians to enter exhaustively documented orders. But a cognitive analysis of the physician's medication ordering task shows that order entry is the last (and least) important step of the entire cognitive therapeutic decision making task. We performed a comparative analysis of these complex cognitive tasks in two working environments, computer-based and paper-based. The results showed that information gathering, selection and interpretation are critical cognitive functions to support the therapeutic decision making. Thus the most important requirement from the physician's perspective would be an efficient display of relevant information provided first in the form of a summarized view of the patient's current treatment, followed by in a more detailed focused display of those items pertinent to the current situation. The CPOE system examined obviously failed to provide the physicians this critical summarized view. Following these results, consistent with users' complaints, the Company decided to engage in a significant re-engineering process of their application.
Pelayo
Sylvia
S
EVALAB, EA 2694, Faculty of Medicine, Lille, France.spelayo@univ-lille2.fr
Leroy
Nicolas
N
Guerlinger
Sandra
S
Degoulet
Patrice
P
Meaux
Jean-Jacques
JJ
Beuscart-Zéphir
Marie-Catherine
MC
D003071:Cognition; D003201:Computers; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors; D008510:Medication Systems, Hospital; D010820:Physicians