I work to improve decisions by clinicians and patients. My focus is on how to facilitate good decisions through health information technology (IT) such as electronic health records, personal health records, and patient portals.
One of my primary areas of focus is the relationship between IT design, cognition, and decision-making. I am keenly interested in good information design and its potential for enabling better decisions. I published some of the foundational articles on health numeracy and risk communication through graphics and conducted experiments showing that effective information design reduced differences between high- and low-numeracy patients. I'm currently involved in a collaboration to develop novel passive sensor systems in smart phones and process/present the data in a way that is informative to patients and their healthcare providers. I am also working on ways to improve physician prescribing decisions through "nudges" informed by behavioral economics.
One area of interest is patient access to medical records. I’m extremely interested in how our national policies guaranteeing patients access to their own electronic data might affect decisions and outcomes. I have conducted statewide and nationwide surveys to examine adoption of these new technologies, as well as smaller-scale interview studies to explore the serious challenges chronically ill patients face in managing their own medical information. I’ve also analyzed EHR data to track the socioeconomic disparities in information access that are typically related to the digital divide. This series of projects is planned to culminate in a cohort study to identify effects of information access.
I seek to inform informatics policy through rigorous health IT evaluation studies. It is critical to study implementation successes and failures during the ongoing transformation of US healthcare by electronic health records and other technologies. I have applied both qualitativeand quantitative methods to this issue. In a multiyear project that is now nearing completion, I mined clinical EHR data to develop novel measures to capture differences in how physicians were using the same technology, and linked these usage differences to differences in healthcare quality.
A partial list of my publications is provided below on this page, with the NCBI version of the list available here.
I am also enthusiastic about teaching informaticists, medical students, and the public. I direct the Weill Cornell master's program in health informatics and teach the research methods course. I also direct the biostatistics/epidemiology module for medical students and guest-lecture on statistical literacy for journalists. (My favorite student evaluation as a statistics educator: "She really made a dull, sorry subject very interesting!")
I am delighted to acknowledge the support of the Agency for Healthcare Research and Quality and the National Science Foundation.