{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T07:58:48Z","timestamp":1792569528832,"version":"4.5.0"},"reference-count":62,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Limited research exists on patient knowledge\/cognition or \u201cgetting inside patients' heads.\u201d Because patients possess unique and privileged knowledge, clinicians need this information to make patient-centered and coordinated treatment planning decisions. To achieve patient-centered care, we characterize patient knowledge and contributions to the clinical information space.<\/jats:p><jats:p>\n          Methods and Objectives\u2003In a theoretical overview, we explore the relevance of patient knowledge to care provision, apply historical perspectives of knowledge acquisition to patient knowledge, propose a representation of patient knowledge types across the continuum of care, and include illustrative vignettes about Mr. Jones. We highlight how the field of human factors (a core competency of health informatics) provides a perspective and methods for eliciting and characterizing patient knowledge.<\/jats:p><jats:p>\n          Conclusion\u2003Patients play a vital role in the clinical information space by possessing and sharing unique knowledge relevant to the clinical picture. Without a patient's contributions, the clinical picture of the patient is incomplete. A human factors perspective informs patient-centered care and health information technology solutions to support clinical information sharing.<\/jats:p>","DOI":"10.1055\/s-0041-1723022","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:02:29Z","timestamp":1614211349000},"page":"133-140","source":"Crossref","is-referenced-by-count":21,"title":["Patients Are Knowledge Workers in the Clinical Information Space"],"prefix":"10.1055","volume":"12","author":[{"given":"Elizabeth Lerner","family":"Papautsky","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Patterson","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"102972","DOI":"10.1016\/j.apergo.2019.102972","article-title":"Patient ergonomics: 10-year mapping review of patient-centered human factors","volume":"82","author":"R J Holden","year":"2020","journal-title":"Appl Ergon"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1093\/jamia\/ocy132","article-title":"AMIA Board white paper: AMIA 2017 core competencies for applied health informatics education at the master's degree level","volume":"25","author":"A L Valenta","year":"2018","journal-title":"J Am Med Inform Assoc"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/BF00989485","article-title":"Managing chronic illness at home: three lines of work","volume":"8","author":"J Corbin","year":"1985","journal-title":"Qual Sociol"},{"key":"ref5","volume-title":"Joint Cognitive Systems: Patterns in Cognitive Systems Engineering","author":"E Hollnagel","year":"2006"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1518\/001872008X288385","article-title":"Naturalistic decision making","volume":"50","author":"G Klein","year":"2008","journal-title":"Hum Factors"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1037\/0033-295X.100.3.363","article-title":"The role of deliberate practice in the acquisition of expert performance","volume":"100","author":"K A Ericsson","year":"1993","journal-title":"Psychol Rev"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1080\/00140139.2013.838643","article-title":"SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients","volume":"56","author":"R J Holden","year":"2013","journal-title":"Ergonomics"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1001\/jamapediatrics.2016.4812","article-title":"Families as partners in hospital error and adverse event surveillance","volume":"171","author":"A Khan","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"e154608","DOI":"10.1001\/jamapediatrics.2015.4608","article-title":"Parent-reported errors and adverse events in hospitalized children","volume":"170","author":"A Khan","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/ACM.0000000000001017","article-title":"Contextual errors in medical decision making: overlooked and understudied","volume":"91","author":"S J Weiner","year":"2016","journal-title":"Acad Med"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1186\/1471-2458-10-459","article-title":"Health in the \u2018hidden population\u2019 of people with low literacy. A systematic review of the literature","volume":"10","author":"P Easton","year":"2010","journal-title":"BMC Public Health"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"N D Berkman","year":"2011","journal-title":"Ann Intern Med"},{"issue":"07","key":"ref18","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1177\/1049732316665347","article-title":"Navigating the decision space: shared medical decision making as distributed cognition","volume":"27","author":"K D Lippa","year":"2017","journal-title":"Qual Health Res"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1136\/bmj.326.7402.1276","article-title":"Patients are experts in their own field","volume":"326","author":"I Kennedy","year":"2003","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"9454506","DOI":"10.1155\/2016\/9454506","article-title":"The expert patient and chronic respiratory diseases","volume":"2016","author":"L P Boulet","year":"2016","journal-title":"Can Respir J"},{"key":"ref21","volume-title":"Expert Patient","year":"2001"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/S0140-6736(02)07959-X","article-title":"Partnerships between expert patients and physicians","volume":"359","author":"K Lorig","year":"2002","journal-title":"Lancet"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1136\/bmj.328.7442.723","article-title":"\u201cExpert patient\u201d\u2014dream or nightmare?","volume":"328","author":"J Shaw","year":"2004","journal-title":"BMJ"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"227","DOI":"10.7861\/clinmedicine.2-3-227","article-title":"The expert patient: a new approach to chronic disease management for the twenty-first century","volume":"2","author":"R L Tattersall","year":"2002","journal-title":"Clin Med (Lond)"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/0270467604265061","article-title":"Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education","volume":"24","author":"P Benner","year":"2004","journal-title":"Bull Sci Technol Soc"},{"issue":"11","key":"ref26","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1111\/j.1553-2712.2008.00227.x","article-title":"Deliberate practice and acquisition of expert performance: a general overview","volume":"15","author":"K A Ericsson","year":"2008","journal-title":"Acad Emerg Med"},{"key":"ref27","doi-asserted-by":"crossref","DOI":"10.1017\/9781316480748","volume-title":"The Cambridge Handbook of Expertise and Expert Performance","author":"K A Ericsson","year":"2018"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s10111-018-0491-1","article-title":"Understanding how primary care clinicians make sense of chronic pain","volume":"20","author":"L G Militello","year":"2018","journal-title":"Cogn Technol Work"},{"issue":"01","key":"ref29","first-page":"162","article-title":"Evaluating a modular decision support application for colorectal cancer screening","volume":"8","author":"L G Militello","year":"2017","journal-title":"Appl Clin Inform"},{"issue":"08","key":"ref30","first-page":"485","article-title":"\u201cWorkin' on our night moves\u201d: how residents prepare for shift handoffs","volume":"44","author":"L G Militello","year":"2018","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"04","key":"ref31","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s10111-018-0486-y","article-title":"Hidden complexities in information flow between primary and specialty care clinics","volume":"20","author":"L G Militello","year":"2018","journal-title":"Cogn Technol Work"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1037\/0096-3445.118.3.219","article-title":"Implicit learning and tacit knowledge","volume":"118","author":"A S Reber","year":"1989","journal-title":"J Exp Psychol Gen"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1518\/001872008X250601","article-title":"Everyday expertise: cognitive demands in diabetes self-management","volume":"50","author":"K D Lippa","year":"2008","journal-title":"Hum Factors"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"103107","DOI":"10.1016\/j.apergo.2020.103107","article-title":"Patient decision-making personas: an application of a patient-centered cognitive task analysis (P-CTA)","volume":"87","author":"R J Holden","year":"2020","journal-title":"Appl Ergon"},{"issue":"155","key":"ref35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0031819100066110","article-title":"The logic of tacit inference","volume":"41","author":"M Polanyi","year":"1966","journal-title":"Philosophy"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.apergo.2014.09.009","article-title":"The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers","volume":"47","author":"R J Holden","year":"2015","journal-title":"Appl Ergon"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1080\/00140139.2016.1168529","article-title":"Macroergonomic factors in the patient work system: examining the context of patients with chronic illness","volume":"60","author":"R J Holden","year":"2017","journal-title":"Ergonomics"},{"issue":"01","key":"ref38","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1136\/amiajnl-2014-002826","article-title":"Transforming consumer health informatics through a patient work framework: connecting patients to context","volume":"22","author":"R S Valdez","year":"2015","journal-title":"J Am Med Inform Assoc"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.1093\/jamia\/ocu031","article-title":"Technical infrastructure implications of the patient work framework","volume":"22","author":"R S Valdez","year":"2015","journal-title":"J Am Med Inform Assoc"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/20476965.2017.1390060","article-title":"Infinicare framework for integrated understanding of health-related activities in clinical and daily-living contexts","volume":"7","author":"M Ozkaynak","year":"2017","journal-title":"Health Syst (Basingstoke)"},{"issue":"06","key":"ref41","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.hrtlng.2019.05.012","article-title":"Knowledge among patients with heart failure: A narrative synthesis of qualitative research","volume":"48","author":"C Daley","year":"2019","journal-title":"Heart Lung"},{"key":"ref42","volume-title":"The Landmarks of Tomorrow: On Economic and Social Progress in the Twentieth-Century","author":"P F Drucker","year":"1959"},{"issue":"19","key":"ref44","doi-asserted-by":"crossref","first-page":"2469","DOI":"10.1001\/jama.288.19.2469","article-title":"Patient self-management of chronic disease in primary care","volume":"288","author":"T Bodenheimer","year":"2002","journal-title":"JAMA"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"5324","DOI":"10.1145\/2858036.2858240","article-title":"Closing the gap: Supporting patients' transition to self-management after hospitalization","author":"A H Pollack","year":"2016","journal-title":"Proc SIGCHI Conf Hum Factor Comput Syst"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"103033","DOI":"10.1016\/j.apergo.2019.103033","article-title":"SEIPS 3.0: Human-centered design of the patient journey for patient safety","volume":"84","author":"P Carayon","year":"2020","journal-title":"Appl Ergon"},{"issue":"02","key":"ref48","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1080\/0284186X.2016.1267402","article-title":"Patient empowerment: a systematic review of questionnaires measuring empowerment in cancer patients","volume":"56","author":"N B Eskildsen","year":"2017","journal-title":"Acta Oncol"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1136\/bmj.39246.581169.80","article-title":"Effectiveness of strategies for informing, educating, and involving patients","volume":"335","author":"A Coulter","year":"2007","journal-title":"BMJ"},{"issue":"04","key":"ref52","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1197\/jamia.M2888","article-title":"A systematic review of patient acceptance of consumer health information technology","volume":"16","author":"C KL Or","year":"2009","journal-title":"J Am Med Inform Assoc"},{"issue":"02","key":"ref53","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1287\/orsc.12.2.198.10116","article-title":"Knowledge and organization: a social-practice perspective","volume":"12","author":"J S Brown","year":"2001","journal-title":"Organ Sci"},{"issue":"01","key":"ref54","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/ddg.12905","article-title":"Self-detection frequency and recognition patterns in medium to high-risk cutaneous melanoma patients","volume":"15","author":"A Sindrilaru","year":"2017","journal-title":"J Dtsch Dermatol Ges"},{"issue":"05","key":"ref55","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/her\/cyu023","article-title":"A matter of trust: patient barriers to primary medication adherence","volume":"29","author":"J M Polinski","year":"2014","journal-title":"Health Educ Res"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.312.7031.629","article-title":"Patients, society, and the increase in self medication","volume":"312","author":"A Blenkinsopp","year":"1996","journal-title":"BMJ"},{"issue":"03","key":"ref57","doi-asserted-by":"crossref","first-page":"e0194409","DOI":"10.1371\/journal.pone.0194409","article-title":"Patient and physician characteristics affect adherence to screening mammography: a population-based cohort study","volume":"13","author":"D Katz","year":"2018","journal-title":"PLoS One"},{"issue":"04","key":"ref58","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1177\/1708538117742830","article-title":"Routine colonoscopy, diabetic eye care, mammogram and pap smear screening in vascular surgery patients","volume":"26","author":"Y Lee","year":"2018","journal-title":"Vascular"},{"issue":"04","key":"ref59","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1055\/s-0038-1675810","article-title":"Self-care support for patients with gastrointestinal cancer: iCancerHealth","volume":"9","author":"D L Berry","year":"2018","journal-title":"Appl Clin Inform"},{"issue":"04","key":"ref60","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.4338\/ACI-2017-06-RA-0111","article-title":"Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment","volume":"8","author":"J S Ancker","year":"2017","journal-title":"Appl Clin Inform"},{"issue":"02","key":"ref61","doi-asserted-by":"crossref","first-page":"383","DOI":"10.4338\/ACI-2014-11-RA-0109","article-title":"A concise and practical framework for the development and usability evaluation of patient information websites","volume":"6","author":"L W Peute","year":"2015","journal-title":"Appl Clin Inform"},{"issue":"03","key":"ref62","doi-asserted-by":"crossref","first-page":"765","DOI":"10.4338\/ACI-2016-01-RA-0014","article-title":"Patient education for consumer-mediated HIE: a pilot randomized controlled trial of the department of veterans affairs Blue Button","volume":"7","author":"C L Turvey","year":"2016","journal-title":"Appl Clin Inform"},{"issue":"10","key":"ref63","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1038\/s41591-020-1080-4","article-title":"Patient researchers - the missing link?","volume":"26","author":"S Riggare","year":"2020","journal-title":"Nat Med"},{"issue":"10","key":"ref64","doi-asserted-by":"crossref","first-page":"e22005","DOI":"10.2196\/22005","article-title":"Brain tumor discussions on Twitter (#BTSM): social network analysis","volume":"22","author":"J T Feliciano","year":"2020","journal-title":"J Med Internet Res"},{"issue":"04","key":"ref65","doi-asserted-by":"crossref","first-page":"304","DOI":"10.17294\/2330-0698.1753","article-title":"A history of #BCSM and insights for patient-centered online interaction and engagement","volume":"7","author":"M S Katz","year":"2020","journal-title":"J Patient Cent Res Rev"},{"key":"ref66","first-page":"113426","article-title":"How and why patients made Long Covid","author":"F Callard","year":"2020","journal-title":"Soc Sci Med"},{"issue":"03","key":"ref68","first-page":"80","article-title":"Portraits of patient cognition: how patients understand diabetes self-care","volume":"40","author":"K D Lippa","year":"2008","journal-title":"Can J Nurs Res"},{"issue":"01","key":"ref69","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1518\/001872008X250601","article-title":"Everyday expertise: cognitive demands in diabetes selfmanagement","volume":"50","author":"K D Lippa","year":"2008","journal-title":"Hum Factors"},{"issue":"01","key":"ref70","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/jamiaopen\/ooz060","article-title":"Citizen science to further precision medicine: from vision to implementation","volume":"3","author":"C Petersen","year":"2019","journal-title":"JAMIA Open"},{"key":"ref71","volume-title":"Personal Knowledge: Towards a Post-Critical Philosophy","author":"M Polanyi","year":"1958"},{"issue":"02","key":"ref72","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1037\/0003-066X.39.2.93","article-title":"Education and thinking: the role of knowledge","volume":"39","author":"R Glaser","year":"1984","journal-title":"Am Psychol"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1723022.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:03:26Z","timestamp":1614211406000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1723022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":62,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2021,1,6]]},"published-print":{"date-parts":[[2021,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1723022","relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}