# A Human Factors Investigation of Health Information Exchange: Tools to Support Providers’ Coordination of Medications

> **NIH VA I01** · RLR VA MEDICAL CENTER · 2020 · —

## Abstract

Background/Rationale: Millions of Veterans receive care from both VA and non-VA healthcare
providers. Health information exchange (HIE) technologies are relatively new and are
implemented across VA. HIE allows VA providers to send and receive medication data from
non-VA medical institutions. This data exchange is important to coordinate patients'
medications, reconcile medications to reflect what the patient is actually taking, and reduce the
risk of adverse drug events. With the recent Veterans Access, Choice, and Accountability Act of
2014, it is even more critical to foster effective HIE that improves provider decision-making.
Reports indicate, however, that VA's HIE technologies are inadequately supporting medication
reconciliation tasks and are underutilized by providers. In addition, HIE medication data and VA
medication orders are shown in separate displays, limiting the utility of HIE data and impeding
providers' ability to coordinate medications.
Objectives: The study objective is to identify providers' underlying cognitive needs in order to
develop a set of technology design guidelines for presenting VA and HIE medication data. We
hypothesize that, compared to current VA technologies, design guidelines from this research
can significantly improve the quality and safety of providers' decision-making, including the
efficiency and accuracy of medication reconciliation. Specific aims are as follows:
Aim 1: Assess the strengths and weaknesses of VA's HIE interfaces for supporting providers'
workflow and decision-making processes for medication reconciliation in the context of care.
Aim 1 will yield an initial set of HIE design guidelines to support providers' workflow.
Aim 2: Identify the cognitive strategies that providers use for medication reconciliation tasks.
Aim 2 will yield an initial set of HIE design guidelines to support providers' cognition. Guidelines
from Aims 1, 2 will be translated into a novel prototype for the VA-HIE interface.
Aim 3: Evaluate the novel VA-HIE interface to assess whether the design guidelines
significantly improve the quality and safety of providers' performance.
Methods: For Aim 1, field observations, interviews, and remote usability tests will be conducted
with inpatient and outpatient providers (prescribers and pharmacists) to generate a baseline,
exploratory assessment of how well HIE interfaces support provider workflow. Qualitative data
will be collected across four geographically dispersed VA Medical Centers. In Aim 2, card sorts
and simulation interviews will be conducted with inpatient and outpatient providers to identify the
underlying cognitive processes involved in medication reconciliation tasks. For Aim 3, we will
conduct a randomized controlled trial with providers in a simulated environment and collect
qualitative and quantitative data in order to evaluate whether the design guidelines significantly
improves providers' efficiency and accuracy of medication reconciliation.
Significance: This r...

## Key facts

- **NIH application ID:** 9693609
- **Project number:** 5I01HX002287-02
- **Recipient organization:** RLR VA MEDICAL CENTER
- **Principal Investigator:** MICHAEL WEINER
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9693609

## Citation

> US National Institutes of Health, RePORTER application 9693609, A Human Factors Investigation of Health Information Exchange: Tools to Support Providers’ Coordination of Medications (5I01HX002287-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9693609. Licensed CC0.

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