Usability of human-computer interaction in neonatal care

  • Kevin R Dufendach
    Corresponding author. Cincinnati Children's Hospital Medical Center, Division of Biomedical Informatics, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
    Department of Pediatrics, University of Cincinnati College of Medicine, USA

    Perinatal Institute, Cincinnati Children's Hospital Medical Center, USA

    Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, USA
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  • Adriana Navarro-Sainz
    School of Information, University of Cincinnati, USA
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  • Kristen LW Webster
    Patient Safety, Regulatory, & Accreditation, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, USA
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Published:October 12, 2022DOI:


      • Incorporating human-computer interaction usability principles in medical system design can improve quality, efficiency, and safety in healthcare delivery.
      • Poor usability of electronic health record systems is associated with increased burnout among clinicians.
      • Specific foci for improving usability in neonatology include prenatal care, delivery room resuscitation, routine newborn care, interhospital transfers, nutrition and fluids, complex medication management, and documentation.
      • Strategies for optimizing the visualization of neonatal nutrition, fluid, and medication administration data
      • Use of data analytics methods, including machine learning and natural language processing, to analyze neonatal data and facilitate clinical decision support
      • Methods to communicate important maternal health information that affects the infant's care while still supporting maternal health privacy
      • Strategies to support a shared neonatal team workflow that encourages a shared mental model and decreased duplicate documentation.


      While a goal for Electronic Health Record (EHR) technologies was to improve quality, efficiency, and safety, the usability of EHRs has remained poor. The relation to patient harm and user satisfaction cannot be ignored. Optimization of EHR usability is imperative to improving the outcomes for critically ill patients, especially neonates who are at the extremes of physiologic variability. Further development and integration of metadata with predictive modeling and clinical protocols can support provider decision making, increase efficiency and safety, and reduce clinician burnout. This paper reviews EHR usability and identifies opportunities to improve the EHR specific to neonatal care.


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