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• Health information technologies are an interactive element, among many, that toge<strong>the</strong>r<br />
shape <strong>the</strong> behavior <strong>of</strong> complex socio-technical systems.<br />
• We need clinically-situated research to understand cognitive<br />
requirements in advance <strong>of</strong> proposing ‘solutions’—how do <strong>the</strong><br />
elements <strong>of</strong> <strong>the</strong> cognitive system interact to affect and effect<br />
outcomes?<br />
• Implementation strategies should include robust processes for<br />
identifying workarounds—markers <strong>of</strong> an unintended impact on<br />
frontline clinical processes.<br />
• Healthcare organizations need persistent surveillance systems that<br />
are sensitive to side-effects <strong>of</strong> change in technologies, policies,<br />
processes, purchasing, tasks...<br />
• Usability science and user research are insufficient to understand <strong>the</strong><br />
requirements for information technologies in domains and pr<strong>of</strong>essions<br />
where <strong>the</strong>re is high consequence for failure.<br />
73<br />
NPSF Pr<strong>of</strong>essional Learning Series<br />
May 31, 2012