Else Nygren

Reading the Medical Record I. Analysis of physicians ways of reading the medical record

Physicians were interviewed about their routines in everyday use of the medical record. From the interviews, we conclude that the medical record is a well functioning working instrument for the experienced physician. Using the medical record as a basis for decision making involves interpretation of format, layout and other textural features of the type-written data. Interpretation of these features provides effective guidance in the process of searching, reading and assessing the relevance of different items of information in the record. It seems that this is a skill which is an integrated part of diagnostic expertise. This skill plays an important role in decision making based on the large amount of information about a patient, which is exhibited to the reader in the medical record. This finding has implications for the design of user interfaces for reading computerized medical records.

Helping clinicians to find data and avoid delays

One major criticism of paper medical records is the time and effort required to find data items or to gain an overview. Computerisation does not necessarily help. To help clinicians find data faster and with less effort, everyone designing and writing in records needs to understand how and why we search records and the design features that make searching easier. This paper describes how clinicians search medical records and how to improve record design, whether on paper or computer, to help clinicians find all the data they need without delay.

The art of the obvious

In addition to normal reading, knowledge can be gained from a paper document by pattern recognition and encoding of characteristics of the information media. There are reasons to believe that this can be done automatically with very little attentional demand. The knowledge gained is accessible to consciousness and can be used for task components like orientation, navigation, detection of changes and as a complement to normal reading. When information is computerized, and is read from a screen instead of from a paper, the conditions for automaticity are often radically changed. In most cases the reader has to gain the corresponding knowledge by effortful cognitive processes. This means adding to the cognitive load leaving less attentional capacity for the main task at hand. This problem can be avoided by a careful analysis of a reading task into its automatic and non-automatic components, followed by a dedicated user interface design where information relevant for orientation, navigation, etc. is presented in a way that the reader can perceive rather than read.

Reading the medical record. II. Design of a human-computer interface for basic reading of computerized medical records

A user interface for reading the medical record was designed and implemented on a workstation with a 19-inch colour screen. The text is presented on imitations of paper-pages. The pages are organized in bundles which are dynamically connected to scrollable index lists. The turning of pages on the screen is the fundamental concept of the interface. A page can be turned by a mouse-click or by a circular mouse-movement. Elaborated feedback is given to the user in order to provide effortless orientation and navigation. The interface supports the basic ways of use identified in our analyses of reading habits. It also enables human perceptual and cognitive skills to be used. It seems very easy to learn and efficient in use.

Analysis of information utilization (AIU)

Analysis of information utilisation (AIU) is a method for specifying how information entities encountered in information analysis are being physically manipulated in the work situation undergoing a ...

Grooming analysis modeling the social interactions of online discussion groups

This chapter looks into different ways of analyzing and modeling the time dependent development of social interactions between members in online discussion groups. Social grooming is an activity in which individuals bond and reinforce social structures. To groom someone can be for instance to mention someones name in a discussion or to cite something said by that person. The number of grooms received by a group member can be analyzed and used as an indicator of the social status in the group. By performing grooming analysis it is possible to attain information about how the relative status of the group members changes over time. The data in this study is taken from two different international online discussion groups. A validation showed that the estimate of status based on the grooming analysis showed remarkable correspondence with the collective status ranking performed by a group of independent evaluators.