Clinical communication, interruption and the design of e-health
September 23, 2014 § Leave a comment
The different ways clinicians interact does not just shape the success of the communication act. Our propensity to interrupt each other, and multitask as we handle communication tasks alongside other duties, has a direct effect on how well we carry out everything we do. Interruption for example has the capacity to distort human memory processes, and lead to memory lapses as well as memory distortions.
Earlier this year I was interviewed by Dr. Robert Wachter, the Editor of the Agency for Healthcare Research and Quality (AHRQ) WebM&M. In that interview we covered the roles that interruption and multitasking play in patient safety, discussing both their risks, as well as strategies for minimising their effects. The interview also looked at the implications these communication and task management styles have for the design of information technologies.
The transcript of the interview as well as the podcast are available here.
A related 2012 editorial on the research challenges associated with interruption appeared in BMJ Quality and safety.
It is clear that our clinical information systems are not designed to be used in busy, interrupt-driven environments, and that they suffer because of it. Not only do they not fit the way people of necessity communicate and work, they lead to additional risks and have the potential to harm patients. It perplexes me that information system designers still work on the blind assumption that their users are giving their full attention to the software systems they have built. E-health systems need to be tolerant of interruption, and must be designed to support recovery from such events. Memory prompts, task markers, and retention of context once an action has been completed, are essential for the safe design of e-health systems.