title: When you come to a fork in the road, take it: strategy selection in order entry.
abstract: This study investigates how CPOE system users choose data input strategies for entering clinical orders. Complex systems often allow more than one way to complete a task. However, the appropriate entry strategy in the context of a specific clinical workflow situation may not be apparent to users. We have conducted a cognitive analysis of user interaction strategies for entering IV injection orders using a commercial CPOE system. We characterized the set of available information resources in the system interface and in the users' memory, and evaluated how effectively the application supported decision-making processes. Seven internal medicine residents participated in an experiment entering IV heparin orders to manage anticoagulation therapy. The analysis showed that efficiency was contingent upon high level of procedural and conceptual system knowledge. CPOE interface design needs to conform to decision-making and workflow processes if the technology is to become an effective clinical tool.
authors.affiliation: Laboratory of Decision Making and Cognition, Department of Biomedical Informatics, Columbia University, New York, NY, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Horsky
authors.forename: David R
authors.initials: DR
authors.lastname: Kaufman
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D003071:Cognition; D003657:Decision Making; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D007388:Internal Medicine; D007396:Internship and Residency; D050316:Medical Order Entry Systems; D014584:User-Computer Interface
chemical_list: D000925:Anticoagulants; D006493:Heparin