For health IT to benefit health and healthcare, it must be useable by – and useful to – patients and clinicians.  This is precisely where the discipline of human factors and ergonomics (HFE) serves as an essential foundation for the development, implementation, and use of high-quality health information systems and practices.  HFE improves overall performance through study of interactions among humans and other elements of a system.

We recently published a forward-looking article in a special issue of Applied Ergonomics, reviewing key initiatives funded by the Office of the National Coordinator for Health Information Technology (ONC) and the Agency for Healthcare Research and Quality (AHRQ).  In the article, we illustrate how HFE methods and approaches can improve the design, implementation, and use of health IT for clinicians and consumers and identify the work that remains.

Advancing Human Factors in Health IT through Policy and Research

Over the last decade, as doctors’ offices and hospitals implemented health IT, ONC and AHRQ prioritized funding programs and projects focused on the use of HFE in health IT design, implementation, and use.  Collectively, these efforts have significantly advanced the application of HFE knowledge and methods in the field of health IT and the healthcare industry’s understanding of relevant issues and challenges.  These studies have identified important design problems such as poorly designed interfaces or inadequate training, or sociotechnical factors that influence system usability and usefulness such as team dynamics and roles or integration with local IT systems.

Given the complexities of healthcare and health IT, new and innovative HFE work is needed to fully benefit from HFE knowledge, principles, and methods to affect the design, implementation, and use of health IT at a broader scale. The article makes several recommendations, including:

• Key stakeholders should use HFE methods and processes when purchasing and implementing health IT systems;
• New HFE studies of health IT should specifically address design and development;
• Research that evaluates the full cycle of development, implementation, use, evaluation, and improvement should be supported;
• New and improved methods and approaches should be developed;
• Researchers and policymakers must translate research findings into useful resources for stakeholders; and
• A more systematic understanding of where we are in designing, deploying, and using useful health IT is needed.

Looking Ahead

Knowledge about how to best use HFE to improve health IT continues to be an area of great need as evidenced by ONC and AHRQ-funded work, and in recent presentations at the American Medical Informatics Association, the Human Factors and Ergonomics Society, and other expert forums and professional societies.  ONC looks forward to working with stakeholders in the public and private sector to advance these recommendations.

Editor’s Note: Applied Ergonomics recently published a special issue on advancing theory and methods in human factors and ergonomics for health and healthcare dedicated to the late Bentzi Karsh.  The special issue examines state-of-the-art and forward-looking work at the intersection of HFE and health or healthcare that is innovative, applied, multidisciplinary, and clearly advances science and practice by developing, applying, or adapting novel theories and methods.  Dr. Karsh was an industrial and systems engineer who focused on, among many things, the intersection of HFE and health IT usability, safety, and use issues.  He was a leading voice in the field and his work helped advance our understanding of the need to attend to HFE issues in health IT.  Accordingly, topics in this issue relevant to health information technology include user-centered design, usability, adoption, implementation, and acceptance.