Gains, losses, and uncertainties from computerizing referrals and consultations

Michael Weiner, April Savoy, Barry C. Barker

Research output: Contribution to journalArticle


Consultations entail transitions in care between referrers and consultants, as patients visit different clinicians and care sites. This complex process has been consistently prone to communication breakdowns. Despite expectations and benefits of electronic health records (EHRs), incomplete, vague, or inappropriate referrals continue to hinder consultations; referrals can be sent to the wrong specialty service; and consultation findings frequently fail to reach referrers. Due to the inadequate support of interpersonal communication afforded by EHRs, these issues persist. Important aspects of ergonomics and human factors engineering frequently appear overlooked during the design and implementation of EHRs. Usability issues have contributed to delays in medical diagnosis, treatment, and follow-up. Some of these delays contribute to patient harms. Our multidisciplinary team of clinicians and ergonomics professionals reflects on referral and consultation. We describe how computerization in healthcare should benefit from approaches informed and developed through applied ergonomics and human factors.

Original languageEnglish (US)
Article number103227
JournalApplied Ergonomics
StatePublished - Nov 2020


  • Electronic health records
  • Human factors and ergonomics
  • Referral and consultation

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Safety, Risk, Reliability and Quality
  • Engineering (miscellaneous)

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