Advancing cognitive engineering methods to support user interface design for electronic health records

Thankam P. Thyvalikakath, Michael P. Dziabiak, Raymond Johnson, Miguel Humberto Torres-Urquidy, Amit Acharya, Jonathan Yabes, Titus K. Schleyer

Research output: Contribution to journalArticle

20 Scopus citations


Background: Despite many decades of research on the effective development of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow, especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practitioners in the United States. A critical reason for slow adoption is the poor usability of clinical systems, which makes it difficult for providers to navigate through the information and obtain an integrated view of patient data. Objective: In this study, we documented the cognitive processes and information management strategies used by dentists during a typical patient examination. The results will inform the design of a novel electronic dental record interface. Methods: We conducted a cognitive task analysis (CTA) study to observe ten general dentists (five general dentists and five general dental faculty members, each with more than two years of clinical experience) examining three simulated patient cases using a think-aloud protocol. Results: Dentists first reviewed the patient's demographics, chief complaint, medical history and dental history to determine the general status of the patient. Subsequently, they proceeded to examine the patient's intraoral status using radiographs, intraoral images, hard tissue and periodontal tissue information. The results also identified dentists' patterns of navigation through patient's information and additional information needs during a typical clinician-patient encounter. Conclusion: This study reinforced the significance of applying cognitive engineering methods to inform the design of a clinical system. Second, applying CTA to a scenario closely simulating an actual patient encounter helped with capturing participants' knowledge states and decision-making when diagnosing and treating a patient. The resultant knowledge of dentists' patterns of information retrieval and review will significantly contribute to designing flexible and task-appropriate information presentation in electronic dental records.

Original languageEnglish (US)
Pages (from-to)292-302
Number of pages11
JournalInternational Journal of Medical Informatics
Issue number4
StatePublished - Apr 2014


  • Cognitive engineering
  • Cognitive task analysis
  • Electronic dental records
  • Electronic health records
  • System design
  • Usability

ASJC Scopus subject areas

  • Health Informatics

Fingerprint Dive into the research topics of 'Advancing cognitive engineering methods to support user interface design for electronic health records'. Together they form a unique fingerprint.

  • Cite this