title: A multi-site cognitive task analysis for biomedical query mediation.
abstract: To apply cognitive task analyses of the Biomedical query mediation (BQM) processes for EHR data retrieval at multiple sites towards the development of a generic BQM process model.
  
  
  
  We conducted semi-structured interviews with eleven data analysts from five academic institutions and one government agency, and performed cognitive task analyses on their BQM processes. A coding schema was developed through iterative refinement and used to annotate the interview transcripts. The annotated dataset was used to reconstruct and verify each BQM process and to develop a harmonized BQM process model. A survey was conducted to evaluate the face and content validity of this harmonized model.
  
  
  
  The harmonized process model is hierarchical, encompassing tasks, activities, and steps. The face validity evaluation concluded the model to be representative of the BQM process. In the content validity evaluation, out of the 27 tasks for BQM, 19 meet the threshold for semi-valid, including 3 fully valid: "Identify potential index phenotype," "If needed, request EHR database access rights," and "Perform query and present output to medical researcher", and 8 are invalid.
  
  
  
  We aligned the goals of the tasks within the BQM model with the five components of the reference interview. The similarity between the process of BQM and the reference interview is promising and suggests the BQM tasks are powerful for eliciting implicit information needs.
  
  
  
  We contribute a BQM process model based on a multi-site study. This model promises to inform the standardization of the BQM process towards improved communication efficiency and accuracy.
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Hruby
authors.affiliation: Division of Health and Biomedical Informatics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Luke V
authors.initials: LV
authors.lastname: Rasmussen
authors.affiliation: Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Information, University of Michigan, Ann Arbor, MI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Hanauer
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY, USA; The New York Academy of Medicine, New York, NY, USA.
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY, USA; Informatics Institute in School of Medicine, University of Alabama, Birmingham, AL, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Cimino
authors.affiliation: Department of Biomedical Informatics, Columbia University, New York, NY, USA. Electronic address: chunhua@columbia.edu.
authors.forename: Chunhua
authors.initials: C
authors.lastname: Weng
mesh_terms: D003071:Cognition; D003142:Communication; D057225:Data Mining / Q000379:methods*; D016208:Databases, Factual; D006801:Humans; D016247:Information Storage and Retrieval; D008492:Medical Informatics Computing; D013647:Task Performance and Analysis; D014584:User-Computer Interface
keywords: Electronic health records; Information storage and retrieval; Task performance and analysis