Consultations entail transitions in care between referrers and consultants, as patients visit different clinicians and care sites. This complex process has been consistently prone to communication breakdowns. Despite expectations and benefits of electronic health records (EHRs), incomplete, vague, or inappropriate referrals continue to hinder consultations; referrals can be sent to the wrong specialty service; and consultation findings frequently fail to reach referrers. Due to the inadequate support of interpersonal communication afforded by EHRs, these issues persist. Important aspects of ergonomics and human factors engineering frequently appear overlooked during the design and implementation of EHRs. Usability issues have contributed to delays in medical diagnosis, treatment, and follow-up. Some of these delays contribute to patient harms. Our multidisciplinary team of clinicians and ergonomics professionals reflects on referral and consultation. We describe how computerization in healthcare should benefit from approaches informed and developed through applied ergonomics and human factors.

咨询需要转介人和顾问之间的护理过渡，因为患者会访问不同的临床医生和护理地点。这个复杂的过程一直容易出现通信故障。尽管电子健康记录 (EHR) 具有预期和好处，但不完整、模糊或不适当的转介继续阻碍咨询；转介可能会被发送到错误的专业服务；并且咨询结果经常无法传达给推荐人。由于电子病历提供的人际交流支持不足，这些问题仍然存在。在 EHR 的设计和实施过程中，人体工程学和人因工程的重要方面经常被忽视。可用性问题导致了医疗诊断、治疗和随访的延误。其中一些延误会导致患者受到伤害。我们由临床医生和人体工程学专家组成的多学科团队反思转诊和咨询。我们描述了医疗保健中的计算机化应该如何受益于通过应用人体工程学和人为因素了解和开发的方法。