| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Research Paper |
Affiliation of the authors: McGill University, Montreal, Quebec, Canada.
Correspondence and reprints: Vimla L. Patel, PhD, DSc, Centre for Medical Education, McGill University, 1110 Pine Avenue West, Montreal, QC, Canada H3A 1A3; e-mail: <patel{at}hebbg.psych.mcgill.ca>.
Objective: To assess the effects of a computer-based patient record system on human cognition. Computer-based patient record systems can be considered "cognitive artifacts," which shape the way in which health care workers obtain, organize, and reason with knowledge.
Design: Study 1 compared physicians' organization of clinical information in paper-based and computer-based patient records in a diabetes clinic. Study 2 extended the first study to include analysis of doctor–patient–computer interactions, which were recorded on video in their entirety. In Study 3, physicians' interactions with computer-based records were followed through interviews and automatic logging of cases entered in the computer-based patient record.
Results: Results indicate that exposure to the computer-based patient record was associated with changes in physicians' information gathering and reasoning strategies. Differences were found in the content and organization of information, with paper records having a narrative structure, while the computer-based records were organized into discrete items of information. The differences in knowledge organization had an effect on data gathering strategies, where the nature of doctor-patient dialogue was influenced by the structure of the computer-based patient record system.
Conclusion: Technology has a profound influence in shaping cognitive behavior, and the potential effects of cognition on technology design needs to be explored.
This article has been cited by other articles:
 |
|
 |
|
  T. Cohen, B. Blatter, C. Almeida, and V. L. Patel Reevaluating Recovery: Perceived Violations and Preemptive Interventions on Emergency Psychiatry Rounds J. Am. Med. Inform. Assoc., May 1, 2007; 14(3): 312 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Reiling Safe design of healthcare facilities Qual. Saf. Health Care, December 1, 2006; 15(suppl_1): i34 - i40. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Callen, J. I. Westbrook, and J. Braithwaite The Effect of Physicians' Long-term Use of CPOE on Their Test Management Work Practices J. Am. Med. Inform. Assoc., November 1, 2006; 13(6): 643 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Harris, J. C. McGregor, E. N. Perencevich, J. P. Furuno, J. Zhu, D. E. Peterson, and J. Finkelstein The Use and Interpretation of Quasi-Experimental Studies in Medical Informatics J. Am. Med. Inform. Assoc., January 1, 2006; 13(1): 16 - 23. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Embi, T. R. Yackel, J. R. Logan, J. L. Bowen, T. G. Cooney, and P. N. Gorman Impacts of Computerized Physician Documentation in a Teaching Hospital: Perceptions of Faculty and Resident Physicians J. Am. Med. Inform. Assoc., July 1, 2004; 11(4): 300 - 309. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Winkelman and K. J. Leonard Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework J. Am. Med. Inform. Assoc., March 1, 2004; 11(2): 151 - 161. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Patel, J. F. Arocha, and D. R. Kaufman A Primer on Aspects of Cognition for Medical Informatics J. Am. Med. Inform. Assoc., July 1, 2001; 8(4): 324 - 343. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
