title: Task analysis of information technology-mediated medication management in outpatient care.
abstract: OBJECTIVE
  Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care.
  
  
  METHODS
  Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks.
  
  
  METHODS
  Outpatient care in different fields of medicine in six teaching and academic medical centres in the Netherlands and the United States.
  
  
  METHODS
  20 experts. Tasks were divided up into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision making.
  
  
  RESULTS
  The medication management process consists of three components: (i) reviewing the medication situation; (ii) composing a treatment plan; and (iii) accomplishing and communicating a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medications and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of IT in workflow, managing uncertainties and responsibilities, and problem detection.
  
  
  CONCLUSIONS
  All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care.
authors.affiliation: Department of Internal Medicine & Centre for Research and Development of Education, University Medical Centre Utrecht, Utrecht, the Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van Stiphout
authors.affiliation: Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands.|Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands.
authors.forename: J E F
authors.initials: JE
authors.lastname: Zwart-van Rijkom
authors.affiliation: Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Maggio
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.
authors.forename: J E C M
authors.initials: JE
authors.lastname: Aarts
authors.affiliation: Division of General Internal Medicine, Brigham and Women's Hospital, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Bates
authors.affiliation: Departments of Hospital Pharmacy and Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands.
authors.forename: P A F
authors.initials: PA
authors.lastname: Jansen
authors.affiliation: TNO Netherlands Organisation for Applied Scientific Research Earth, Life, and Social Sciences, Soesterberg, the Netherlands.
authors.forename: J M C
authors.initials: JM
authors.lastname: Schraagen
authors.affiliation: Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands.|Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands.
authors.forename: A C G
authors.initials: AC
authors.lastname: Egberts
authors.affiliation: Department of Internal Medicine & Centre for Research and Development of Education, University Medical Centre Utrecht, Utrecht, the Netherlands.
authors.forename: E W M T
authors.initials: EW
authors.lastname: ter Braak
mesh_terms: D000553:Ambulatory Care / Q000379:methods* / Q000458:organization & administration; D000555:Ambulatory Care Information Systems / Q000458:organization & administration*; D008490:Medical Informatics / Q000193:education*; D008508:Medication Errors / Q000517:prevention & control; D008509:Medication Systems / Q000458:organization & administration*; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration; D010595:Pharmacists / Q000592:standards; D010820:Physicians / Q000592:standards; D013647:Task Performance and Analysis
keywords: IT; education; human factors; medication management; task analysis