Category Archives: Uncategorized

EHR: Clumsy Automation Par Excellence

New study finds that physicians spend twice as much time interacting with EHR systems as interacting directly with patients. http://www.beckershospitalreview.com/ehrs/primary-care-physicians-spend-close-to-6-hours-performing-ehr-tasks-study-finds.html http://www.annfammed.org/content/15/5/419.full This is a classical example of clumsy automation. That is, automation that disrupts the normal flow of work, rather … Continue reading

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Muddling Through in the ED

Introduction It has long been recognized that in complex work domains such as management and healthcare, the decision-making behavior of experts often deviates from the prescriptions of analytic or normative logic.  The observed behaviors have been characterized as intuitive, muddling … Continue reading

Cognitive Science, Human Experience, Uncategorized

Models: To Limit or Inform Human Muddling

The team at Mile Two recently created an App (CVDi) to help people to make sense of clinical values associated with cardiovascular health. The App is a direct manipulation interface that allows people to enter and change clinical values and … Continue reading

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Going the Second Mile

I just completed my first month of work outside the walls of the Ivory Tower of academia. After more than forty years as a student and academic, I left Wright State University and joined a small tech start-up in Dayton … Continue reading

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The Reification Problem: The Difference Between Naming and Understanding

In “The Pleasure of Finding Things Out” Richard Feynman tells this story about things his father did that helped teach him to think like a scientist: He had taught me to notice things and one day when I was playing … Continue reading

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The Ultimate Promise of Automation: To Replace or To Engage Humans?

Moshe Vardi (a computer science professor at Rice University in Texas) is reported to have made the following claim at a meeting of the American Association for the Advancement of Science: “We are approaching the time when machines will be … Continue reading

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Robert Wears leading expert on patient safety passes unexpectedly.

Dr. Robert Wears was an Emergency Room Physician and a leading advocate/practitioner of Cognitive Systems Engineering in the healthcare domain.  He was committed to applying state of the art theory and technologies to improve patient safety. This is a great … Continue reading

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Engineering ‘Cognitive Systems’

The term “Cognitive Engineering” was first suggested by Don Norman and it is the title of a chapter in a book (User-Centered System Design -1986) that he co-edited with Stephen Draper. Norman (1986) writes: Cognitive Engineering, a term invented to … Continue reading

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Cognitive Systems Engineering: More than 25 years in

It is a bit of a jolt for me to realize that it has now been more than 25 years since the publication of Rasmussen, Pejtersen and Goodstein’s (1994) important book “Cognitive Systems Engineering.” It is partly a jolt because … Continue reading

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Design: The Ultimate Test of Theory

Kurt Lewin’s quote that “nothing is more practical than a good theory” has been repeated so often that it has become trite. However, few appreciate the complementary implication of this truism. That is, that “the strongest test of a theory … Continue reading

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