Jan Horsky, PhD

Associate Research Scientist
Department of Biomedical Informatics, Columbia University

My research is concerned primarily with investigating the cognitive aspects of human-computer interaction in healthcare environments and with issues related to the development, implementation and evaluation of health information technology (HIT). I am a member of the Laboratory of Decision Making and Cognition, directed by Dr. Vimla Patel. My recent projects included a cognitive usability study of clinicians interacting with a computer-based prescriber order entry systems (CPOE), and the effects of complex information technology systems on medical reasoning, clinical workflow, and the rate of medical errors. An ongoing study looks at the transfer of information between technology and clinicians and its role in collaborative work in critical care environments. We are currently conducting a study in medical, pediatric and psychiatric emergency rooms and at an intensive care unit.

Computer technology in healthcare

The computer is well suited for the processing and presentation of quantifiable information. Medical decisions, however, require more than the availability of current laboratory results and a set of patient data. Decisions about the course of treatment are made with respect to the entire medical and social history of the patient, elucidated by the physician's experience and clinical knowledge. How effective can the computer be in processing and providing qualitative data, significant personal impressions or uncertainties that occur in everyday medical practice? How much information and in what form should be available to prevent a dangerous omission while maintaining intelligibility, clarity, and practicality of use? Is the cognitive effort required to navigate through an electronic system diverting attention from clinical reasoning? Interacting with a comprehensive system that makes suggestions and "catches errors" fundamentally changes not only the way medical decisions are made, but also the working relations among health care professionals. In the end, it is the human user who makes the final decision, but a well-designed support system can make those decisions more appropriate and safe for the patient.

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