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Samore MH, Rubin MA, Weir CR. Supplement on Theory and Innovation in Cognitive Support for Health Care Decision Making Supplement in the Journal of Biomedical Informatics. 2017 Jul 22.
Brief Description: A recently released Supplement to the Journal of Biomedical Informatics addresses expanding cognitive support for individual clinician decision makers using electronic health records (EHR). http://www.sciencedirect.com/science/journal/15320464/71//supp/S There is current widespread clinician dissatisfaction with EHR's. The American Medical Association recently noted "Health IT is misaligned with the cognitive and workflow requirements of medicine." The editorial and nine articles by VA researchers and colleagues uses the dual process theory framework to develop cognitive support for EMR health care decisions making. The dual process theory proposes two "thinking" processes: first System 1, is well-learned associations that spread activation across well-established networks to support rapid pattern-matching automatically and is activated by environmental ques. System 2, is the slow, rule based conscious system requiring active reasoning, deep processing and conscious reasoning to address more complex situations. Both are important in the EMR. EMR designers should simultaneously pursue models involving System 1 and 2 thinking that includes pattern matching, highlighting components requiring attention and providing tools to support the clinician's active control of their information space. This allows cognitive function to be addressed across the full sociotechnical cycle from design to implementation. These articles will help move the discussion of decision-support design for electronic medical records toward greater support for the range of cognitive functions that are needed to provide timely and accurate EMR decision support.