Power of Heuristics to Improve Health Information Technology System Design

Abstract Background  Clinical decision-making can be prone to error if health system design does not match expert clinicians' higher cognitive skills. There is a gap in understanding the need for the importance of heuristics in clinical decision-making. The heuristic approach can provide cognitive support in designing intuitive health information systems for complex cases. Objective We explored complex decision-making by infectious diseases (ID) clinicians focusing on fast and frugal heuristics. We hypothesized that ID clinicians use simple heuristics to understand complex cases using their experience. Methods The study utilized cognitive task analysis and heuristics-based decision modeling. We conducted cognitive interviews and provided clinicians with a fast-and-frugal tree algorithm to convert complex information into simple decision algorithms. We conducted a critical decision method–based analysis to generate if–then logic sentences from the transcript. We conducted a thematic analysis of heuristics and calculated the average time to complete and the number of crucial information in the decision nodes. Results A total of 27 if–then logic heuristics sentences were generated from analyzing the data. The average time to construct the fast-and-frugal trees was 1.65 ± 0.37 minutes, and the average number of crucial pieces of information clinicians focused on was 5.4 ± 3.1. Conclusion Clinicians use shortcut mental models to reduce complex cases into simple mental model algorithms. The innovative use of artificial intelligence could allow clinical decision support systems to focus on creative and intuitive interface design matching the higher cognitive skills of expert clinicians.