The Natural History of Introducing New Information Technology into a High-Risk Environment

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Abstract
In order to study the impact of automation on complex, high consequence domains, we observed the introduction of a new computer based surgical operating room information system and its effect on cardiac anesthesiologists and their tasks. Recently developed operating room monitoring systems show considerable integration of function compared to older, discrete monitoring ensembles. The new systems differ from their predecessors in the method of display, human interface, and automation of functions previously divided between discrete monitoring elements. The results demonstrate how automation, especially clumsy automation, affects practitioner work patterns and suggests that clumsy automation constrains users in specific and significant ways.

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