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. 2018;6(3-4):165-177.
doi: 10.1080/24725838.2018.1456988. Epub 2018 Jun 8.

Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Laboratory Simulation Study

Dustin T Weiler  1   2 , Tyler Satterly  1   2 , Shakaib U Rehman  3   4 , Maury A Nussbaum  5 , Neale R Chumbler  6 , Gary M Fischer  7 , Jason J Saleem  1   2
Affiliations

Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Laboratory Simulation Study

Dustin T Weiler et al. IISE Trans Occup Ergon Hum Factors. 2018.

Abstract

Background: Challenges persist regarding how to integrate computing effectively into the exam room, while maintaining patient-centered care.

Purpose: Our objective was to evaluate a new exam room design with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning.

Methods: In a lab-based experiment, 28 providers used prototypes of the new and older "legacy" outpatient exam room layouts in a within-subject comparison using simulated patient encounters. We measured efficiency, errors, workload, patient-centeredness (proportion of time the provider was focused on the patient), amount of screen sharing with the patient, workflow integration, and provider situation awareness.

Results: There were no statistically significant differences between the exam room layouts for efficiency, errors, or time spent focused on the patient. However, when using the new layout providers spent 75% more time in screen sharing activities with the patient, had 31% lower workload, and gave higher ratings for situation awareness (14%) and workflow integration (17%).

Conclusions: Providers seemed to be unwilling to compromise their focus on the patient when the computer was in a fixed position in the corner of the room and, as a result, experienced greater workload, lower situation awareness, and poorer workflow integration when using the old "legacy" layout. A thoughtful design of the exam room with respect to the computing may positively impact providers' workload, situation awareness, time spent in screen sharing activities, and workflow integration.

Keywords: Computer workstations; Exam room computing; Exam room design; Human-computer interaction; Mental workload; Patient centeredness.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Current design, layout A, with the computer workstation on a fixed desk in the corner of the room.
Figure 2
Figure 2
New design, layout B, with a wall-mounted armature system for the computer monitor.
See this image and copyright information in PMC

References

    1. Asan O, Carayon P, Beasley JW, Montague E. Work system factors influencing physicians’ screen sharing behaviors in primary care encounters. International Journal of Medical Informatics. 2015;84(10):791–798. - PMC - PubMed
    1. Asan OD, Smith P, Montague E. More screen time, less face time–implications for EHR design. Journal of Evaluation in Clinical Practice. 2014;20(6):896–901. - PMC - PubMed
    1. Baker LH, Reifsteck SW, Mann WR. Connected: communication skills for nurses using the electronic helath record. Nurs Econ. 2003;21:85–88. - PubMed
    1. Chen Y, Ngo V, Harrison S, Duong V. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. ACM; 2011. Unpacking exam-room computing: negotiating computer-use in patient-physician interactions; pp. 3343–3352.
    1. Endsley MR. Toward a Theory of Situation Awareness in Dynamic Systems. Human Factors. 1995;37:32–64.

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