Jonathan Nebeker HIT Panel Spring Conference 2014

Jonathan Nebeker M.D.
Dr. Nebeker joined the University of Utah's Division of Geriatrics and the Salt Lake City VA Medical Center in 1998. He acknowledges the generous support of this division and his principal mentors Matthew Samore and Charles Bennett. His research has two main foci: adverse drug events (ADEs) and cognitive support for electronic health record (EHR) systems. He has national leadership roles in the latter.

His early interests involved the epidemiology of ADEs (with John Hurdle and Charlene Weir) and development and evaluation of surveillance rules for ADE prevention and detection (with Brian Sauer, Joanne LaFleur, and Amy Rosen). One of his more controversial findings was that ADE rates were high in a setting of electronic prescribing and numerous safeguards ostensibly designed to prevent ADEs. The implication is that many of these safeguards have low value for preventing ADEs and that safeguards need to be focused on dose-dependent ADEs, which are most common. Subsequently, he developed electronic surveillance rules for ADEs in the VA and community Medicaid settings. These rules are based on epidemiological principles and are designed to be more sensitive and specific than previously published rules.

He is currently interested in translating theoretical frameworks from social and cognitive psychology to medicine for designing and evaluating user interfaces for EHRs (with Charlene Weir and Frank Drews.) He led a project to translate the Contextual Control Model from a branch of Cognitive Systems Engineering. Guided by this translated model, his team developed a new paradigm for graphical user interfaces (GUIs) for EHRs. Instead of focusing on data, which is typical of current EHRs, the GUI focuses on thought- and workflow. The GUIs incorporate ideas from mindset, dual process, and communication theories. They featured information displays that are designed to reduce cognitive effort to understand what is going on with the patient. In a randomized controlled trial versus a widely used traditional interface, the new interfaces were significantly faster—despite minimal training in the unfamiliar interfaces.

Dr. Nebeker also has national leadership roles in VA. He is Director of VA Informatics and Computing Infrastructure (VINCI.) VINCI is a secure, powerful, virtualized computing environment with national clinical data back to 2000. In addition to directing the center, Dr. Nebeker leads GUI development for several applications. Dr. Nebeker is the Clinical Lead for the DoD-VA Integrated EHR Graphical User Interface.