Automation in health care: the need for an ergonomics-based approach

Abstract

Healthcare quality and efficiency challenges degrade outcomes and burden multiple stakeholders. Workforce shortage, burnout, and complexity of workflows necessitate effective support for patients and providers. There is interest in employing automation, or the use of ‘computer[s] [to] carry out… functions that the human operator would normally perform’, in health care to improve delivery of services. However, unique aspects of health care require analysis of workflows across several domains and an understanding of the ways work system factors interact to shape those workflows. Ergonomics has identified key work system issues relevant to effective automation in other industries. Understanding these issues in health care can direct opportunities for the effective use of automation in health care. This article illustrates work system considerations using two example workflows; discusses how those considerations may inform solution design, implementation, and use; and provides future directions to advance the essential role of ergonomics in healthcare automation.

Practitioner Summary

This article highlights the essential role of ergonomics in the effective design, implementation, and use of automation in health care. By discussing unique considerations for automation in health care and through two illustrative examples, we demonstrate the importance of an ergonomics approach for developing automated healthcare solutions.

Keywords:

• Automation
• health care
• health information technology
• workflow
• work system

Acknowledgements

The authors thank Noor Sharif, Gisela Butera, and Diane Tuncer for copy editing support. We also thank Tracy Okubo from the U.S. Department of Health and Human Services (HHS) Office of the Chief Health Information Officer and the Clinovations Government + Health team—which included Crystal Kallem and Nicole Kemper—for their leadership and contributions to the overarching project that examined the use of workflow automation in health care.

Author contributions

T.Z.-C and A.S. led the conception of the article. All authors revised the article critically, provided intellectual content, and approved the final version for submission. The order of authors listed in the manuscript has been approved by both authors. TZ-C served as Chief Scientist at ONC until February 2021 where she provided executive leadership and oversaw the overarching project that examined the use of workflow automation in health care.

Disclosure statement

T.Z.-C. reports no conflicts of interest. A.S. was funded, in part, by the Office of the National Coordinator for Health Information Technology (ONC) through HHS contract number HHSP233201600030I, task order number: HHSP75P00119F37001 with Clinovations Government + Health. R.S.V. serves as a board member of the American Health Information Management Association Foundation, is a member of the Patient-Centered Outcomes Research Institute Audio-Only Care for the Management of Chronic Conditions External Advisory Panel, and is a member of the National Committee for Quality Assurance Health Equity Working Group. R.S.V. is also an associate editor of JAMIA Open.

Protection of human and animal subjects

There were no human and/or animal subjects included in this work.

Data availability statement

No new data were generated or analysed in support of this work.

Additional information

Funding

This work was partially funded by ONC through HHS contract number HHSP233201600030I, task order number: HHSP75P00119F37001 with Clinovations Government + Health. TZ-C was supported by ONC until February 2021 and by the National Library of Medicine at the National Institutes of Health during part of subsequent manuscript preparation activities.