Healthcare, like so many other aspects of life, has been transformed by technology in the past few decades. But technology is only as good as the people who use it. That can be tricky at the clinical level, as healthcare providers have often struggled in the new world of health information technology, or health IT. But getting doctors and other providers to understand and use these new tools effectively is the focus of the research being conducted by Po-Yin Yen, PhD, an assistant professor at Washington University’s Institute for Informatics (I2).
Dr. Yen’s wide-ranging areas of research include usability evaluation, technology acceptance, understanding human actions and workflow analysis, and data utilization and mining. “I try to understand how clinicians adapt to this information technology era,” she says. “With electronic health records, bar codes and portal systems for inpatients and outpatients, there are so many different kinds of technology. How do we support clinicians with these technologies?”
One solution Dr. Yen has proposed: a paradigm shift in health IT implementation from adoption to a focused strategy of adaptation. Issues stemming from poorly designed interfaces, faulty functionality and sheer complexity contribute to health IT adaptation issues, she notes. “The ways in which health IT implementation is evaluated fail to account for complex socio-technical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines,” she says. In short, health IT is about more than the computer — it’s about the environment, the people and their perceptions of what technology can do for them.
So where can researchers and clinicians go from here?
Better Training in a Real-World Environment
Dr. Yen’s research has found that providing appropriate training fosters adaptation. But in many cases, training and support resources are lacking, and communication between clinicians and organizational leadership or the IT department is inefficient. “They are trained, but sometimes it is not sufficient,” she says. “When upgrades occur and the interface changes, they don’t get additional training or support to operate the system.”
What’s more, one of Dr. Yen’s ongoing projects reveals that training is best provided in a real-world environment. “Providers need simulation classes or a mock system to learn how to interact with the technology, what the interface looks like, what the workflow looks like,” she says. “They need to work in an actual environment, like a playground, so they know how to operate it.”
“We all thought technology would help communication, but [different providers] have different ways of recording information, so they have different ways of communicating,” Dr. Yen says. As a result, interdisciplinary collaboration suffers. “People expect everything in the EHR [electronic health record], but sometimes the documentation isn’t consistent, so they can’t find the information or think things are not done,” she says. The trick is to get everyone speaking the same language, in the same way, at the same times in the patient journey.
Streamlining Systematic Reviews
Dr. Yen also studies literature mining for systematic or literature reviews. Clinicians and researchers can drown in a flood of information looking for relevant literature. Academic search engines like Medline or PubMed may deliver 2,000 or more studies in a single search. “That is too many. We need to narrow it down,” Yen says. “Each individual or team has limited time to go through all the literature.” She has helped create an application that calculates similarities among articles based on title, abstract, authors and keywords. It then visualizes those studies. “It’s like a map of articles. It is much easier to navigate, and any clinician or researcher can use the tool to discover research evidence,” she says.
Whether it’s EHRs or literature mining, all of Dr. Yen’s research revolves around one core principle: helping providers use technology, not be overwhelmed by it. “Their job is to take care of patients, not to take care of the technology,” she says. “This way they can focus their full attention on patient care.”
Health IT is about more than the computer — it’s about the environment, the people and their perceptions of what technology can do for them.