Quality and Efficiency of the Clinical Decision-Making Process: Information Overload and Emphasis Framing

The healthcare industry has invested heavily in electronic health records and other clinical information systems in order to improve caregivers' access to information and ability to share information with other care providers. It has been shown that these systems can readily induce in their users a state of information overload, where the volume and complexity of information overwhelms the user, leading to lower decision speed and quality. This research introduces and tests a cognitive technique called “emphasis framing” as an operational tactic to help mitigate the effects of information overload, thereby improving the quality and timeliness of clinical decision-making. Emphasis framing is the highlighting or stressing of some aspect or component of the information being exchanged in order to make it more easily processed, or more likely to be processed, by the recipient. We conducted a controlled laboratory experiment with emergency department physicians experiencing information overload to measure the effect of emphasis framing on two operational performance metrics: (1) the quality of the physician's clinical evaluation, and (2) the efficiency (timeliness) of the physician's clinical decision-making. Our findings show that the emphasis frame helped mitigate the effects of information overload and increased the quality of clinical decision-making. Contrary to expectations, however, we found decision-making took longer with the emphasis frame, reinforcing the need to consider the impacts of quality/speed trade-offs. Implications for theory and practice are discussed.

Duke Scholars

Author Christopher Lindsell Biostatistics & Bioinformatics, Division of Biostatistics