The Story of Taste: Using EEGs and Self-Reports to Understand Consumer Choice

The authors investigate consumers’ willingness to switch from a preferred manufacturer brand to an unfamiliar private-label brand if taste is perceived as identical. Consumer decisions are examined through recordings of electrical brain activity in the form of electroencephalograms (EEGs) and self-reported data captured in surveys. Results reveal a willingness of consumers to switch to a less-expensive brand when the quality is perceived to be the same as the more expensive counterpart. Cost saving options for consumers and advertising considerations for managers are discussed

Incorporating guideline adherence and practice implementation issues into the design of decision support for beta-blocker titration for heart failure

Background: The recognition of and response to undertreatment of heart failure (HF) patients can be complicated. A clinical reminder can facilitate use of guideline-concordant β-blocker titration for HF patients with depressed ejection fraction. However, the design must consider the cognitive demands on the providers and the context of the work. Objective: This study\u27s purpose is to develop requirements for a clinical decision support tool (a clinical reminder) by analyzing the cognitive demands of the task along with the factors in the Cabana framework of physician adherence to guidelines, the health information technology (HIT) sociotechnical framework, and the Promoting Action on Research Implementation in Health Services (PARIHS) framework of health services implementation. It utilizes a tool that extracts information from medical records (including ejection fraction in free text reports) to identify qualifying patients at risk of undertreatment. Methods: We conducted interviews with 17 primary care providers, 5 PharmDs, and 5 Registered Nurses across three Veterans Health Administration outpatient clinics. The interviews were based on cognitive task analysis (CTA) methods and enhanced through the inclusion of the Cabana, HIT sociotechnical, and PARIHS frameworks. The analysis of the interview data led to the development of requirements and a prototype design for a clinical reminder. We conducted a small pilot usability assessment of the clinical reminder using realistic clinical scenarios. Results: We identified organizational challenges (such as time pressures and underuse of pharmacists), knowledge issues regarding the guideline, and information needs regarding patient history and treatment status. We based the design of the clinical reminder on how to best address these challenges. The usability assessment indicated the tool could help the decision and titration processe

Clinical decision support systems and trust in automation: Case of a clinical reminder for titration of beta blockers

Trust in automation depends on more than just the automation itself, but the larger context in which the automation and the human operator are collaborating. This study takes a naturalistic approach to explore providers\u27 trust in a Clinical Decision Support System. Primary Care Providers were shown simulated medical records and a prototype Clinical Reminder indicating that the patient should be titrated with recommended Beta Blockers to address the patient\u27s Heart Failure with reduced ejection fraction. Analysis of responses showed three main themes: Concerns about the medical documentation used to generate the recommendation; Complexity of the patient condition and care delivery context (and how such factors limit possible courses of action); and Concerns about the Clinical Reminder and clinical guideline it is instantiating. These results align with the macrocognitive model of trust and reliance based on sensemaking and flexecution

Test results management and distributed cognition in electronic health record–enabled primary care

Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results