Task analysis of IT-mediated medication management in outpatient care

Aim Educating physicians in the procedural as well as cognitive skills of IT-mediated medication management could be one of the missing links for improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care. Methods Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. Setting: Outpatient care in different fields of medicine in six teaching and academic medical centers in the Netherlands and the United States. Participants: 20 experts. Tasks were decomposed into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision-making. Results The medication management process consists of three components: (1) reviewing the medication situation, (2) composing a treatment plan, and (3) accomplishing and communicate a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medication and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of information technology (IT) in workflow, managing uncertainties and responsibilities, and problem detection. Conclusion All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care