Information chaos in primary care: implications for physician performance and patient safety

• Published in: Journal of the American Board of Family Medicine Vol. 24; no. 6; pp. 745 - 751
• Main Authors: Beasley, John W, Wetterneck, Tosha B, Temte, Jon, Lapin, Jamie A, Smith, Paul, Rivera-Rodriguez, A Joy, Karsh, Ben-Tzion
• Format: Journal Article
• Language: English
• Published: United States 01.11.2011
• Subjects: Clinical Competence; Electronic Health Records; Ergonomics; Humans; Information Management; Patient Safety; Physicians; Practice Management, Medical - organization & administration; Primary Health Care - organization & administration; Workload
• ISSN: 1557-2625; 1558-7118; 1557-2625
• DOI: 10.3122/jabfm.2011.06.100255

The purpose of this article is to explore the concept of information chaos as it applies to the issues of patient safety and physician workload in primary care and to propose a research agenda. We use a human factors engineering perspective to discuss the concept of information chaos in primary care and explore implications for its impact on physician performance and patient safety. Information chaos is comprised of various combinations of information overload, information underload, information scatter, information conflict, and erroneous information. We provide a framework for understanding information chaos, its impact on physician mental workload and situation awareness, and its consequences, and we discuss possible solutions and suggest a research agenda that may lead to methods to reduce the problem. Information chaos is experienced routinely by primary care physicians. This is not just inconvenient, annoying, and frustrating; it has implications for physician performance and patient safety. Additional research is needed to define methods to measure and eventually reduce information chaos.