Senathirajah Interaction Lab

            Enhanced User Experience through User Autonomy and Flexibility in Health Information Technology


Welcome to the home of the research group of Yalini Senathirajah, PhD.

We conduct research on the impact of interaction design on users of health information technology, with an emphasis on electronic health records. Our work has implications for the safety of patients and satisfaction of clinicians.

Dr. Senathirajah's work to develop novel interaction design in electronic health records has been cited in the 2015 Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs, a report chartered by the Board of Directors of the American Medical Informatics Association. Dr. Senathirajah's novel user interface was cited within this set of recommendations for how to resolve the top EHR issues plaguing the healthcare system.

A basic idea: give the nonprogrammer clinician end users the ability to create some tools and interfaces themselves, to let them create interfaces and software better fitting their ways of thinking, actual tasks and contexts.


Research Overview

​Our long-term goal is to understand the impact of interaction design in health information technology on medical cognition, human-computer interaction/efficiency, and system development. In the shorter term, we are identifying design patterns that reduce usability problems in electronic health records. Our approach is to provide a simplifying technology platform. The strength of our approach is its decision to give the nonprogrammer clinician end-user far greater control to design, gather, mashup, visualize and share clinical information in multiple ways.

Read on for more details about the technology we study in our ongoing research projects.

A different approach to electronic health record design.

MedWISER is an experimental clinical system which allows clinician users to create and share the information elements, tools and interfaces they use, via simple (e.g. ‘drag and drop’) interfaces, without programmers. It was created as an example of the new modular, user-composable approach to EHRs, described in a short concept paper.

MedWISER was built at an academic medical center as the dissertation project of Dr. Senathirajah and tested with typical clinicians and patient cases. We continue funded research on the effects of this approach for increasing clinician cognitive support, usefulness, efficiency, task-technology fit, and rapid reconfiguration to meet emerging healthcare needs. We welcome potential collaborators, doctors, nurses, students, and vendors interested in this area of research or interaction design.


Description of MedWISER

Basic Features and Benefits in Brief

Flexibility and User Control

MedWISER is composed of card - small elements that each display one type of information, such as a clinical note, laboratory test panel, graph, timeline, and so on. Widgets can also do a task, such as calculation. iGoogle is an example of a widget-based system.

Essential features are that MedWISER is modular and composable by the user.

Users can:

Interfaces are saved by default; users can create one for an individual patient, as a self-updating template for use by a team, or suitable to a specialty's specific needs.

​Because no programmer is required, departments and groups could create their own interfaces by consensus; the created interface is available instantly and changeable on the fly while considering a case.

Created elements can be shared; other users can select and import them from a list.

Advanced features include:

  • ability to design displays with control logic; for example, displays for decision support for a new disease
  • mashup of note sections

Potential Advantages

The main expected advantages are...
a) ability to make the electronic health record better fit clinician users' needs and ways of
b) rapid adaptability to emergent needs, such as public health emergencies or new clinical concerns/treatments

Cognitive Advantages

  • ability to juxtapose and rearrange any desired elements on the same page could foster insight
  • clinicians can use the screen as a 'scratchpad', changing it as their thinking about the case changes
  • ability to mark specific elements (eg. by changing the header colour) could allow conveying what is most important (e.g. colour coding groups according to diagnostic significance, placing elements in order of priority)
  • 'stickynote' widgets allow inserting text in any place; allowing further 'scratchpad' use

Human Computer Interaction Advantages

Simultaneous viewing of relevant information together on same screen putatively reduces cognitive load, since users need not retain information in memory while searching for other information, nor need to take notes.

Time Savings

  • Avoid repeating search and retrieval of information for the same patient case, for the original user coming back to the case, and for team members caring for the same patient.
  • Leverage standardized but easily changeable templates for specific uses such as a team's common tasks or specialty workups. Templates can be created from previous screens, and modified for each patient when necessary.
  • Create custom lab panels and plot any number of lab results on the same axes may save space and time while fitting user needs precisely.
  • Establish defaults: conventions for layout, to promote consistency when desirable.
  • Facilitate communication/collaboration: shareable interfaces could provide a 'common ground' for teams to discuss the patient's case while looking at the same data.
  • Streamline handoffs: display of only information relevant to specific patient may facilitate handoff discussion; can be changed as condition changes. ‘Stickynote’ widgets can be used to add reminders.

Software Development

Modular architecture in which any widget can be replaced without affecting the rest of the display allows an ecosystem approach, in which different authors or 3rd party widget creators can create and share new elements. The whole system can gradually evolve, and collecting the best components (via user ratings) becomes possible.

Each widget is independent and has an independent javascript environment. New web visualizations can be incorporated easily.

A modular, user-composable 'building blocks' approach should allow flexibility to meet the highly varied needs of different teams, professions (e.g. nurse v. doctor), specialties, institutions.

User-composable means the user can create some elements of his/her own system by selecting and arranging elements (by drag/drop, without knowing programming).

Frequently Asked Questions

Won't giving users control lead to errors, for example if someone leaves out important data and/or shares the interface with others?

This is of course a possibility; it is one area of research. Currently most institutions do not vet user viewing of data to determine if was appropriate, so we do not think this is different than the current condition. However it is important to test experimentally. There may be methods of mitigating such risks if they occur. There are different levels of control and risk; for example, allowing users to arrange the same information on the page is probably less risky than allowing them to create widgets with complex fallible calculations based on new literature; the two cases should be treated differently, with vetting systems for the latter.
Won't users' creating different tools lead to confusion, excess variability, or management issues?

Again, this is certainly possible and may have to be constrained by policy and technical methods. This is an area of research.

Selected Publications

Press/lay Article (U. Pittsburgh Medical School Alumni Magazine):
Program Allows Personalized Approach to Medical Records Heather Boerner Nov 11, 2019
Can an EHR Add-On Reduce Clinician Burnout, Cut Mouse Clicks? Christopher Jason, Nov 13, 2019

Vision Paper:
Important Ingredients for Health Adaptive Information Systems.
Senathirajah, Y., Bakken, S. Medical Informatics Europe, Oslo, Norway, 2011.

The Clinician in the Driver's Seat: Part 1 - A User-composable Electronic Health Record Platform.
Journal of Biomedical Informatics, Senathirajah, Y, Kaufman, D, Bakken S. Nov/Dec 2014 doi:10.1016/j.jbi.2014.09.002.

Clinician in the Driver’s Seat: Part 2 - Intelligent Uses of Space in a Drag/drop User-composable Electronic Health Record.
Senathirajah, Y, Kaufman, D, Bakken S. Journal of Biomedical Informatics, Nov/Dec 2014.

Essential Questions: Accuracy, errors and user perceptions in a drag/drop user-composable Electronic Health Record.
Senathirajah Y, Kaufman D, Bakken S. Stud Health Technol Inform. 2013;194:181-7. (Medinfo preconference paper award).

Safer Design - Composable EHRs and Mechanisms for Safety.
Senathirajah, Y. Stud Health Technol Inform. 2015;218:40602. PMID: 26262532

User-composable Electronic Health Record Improves Efficiency of Clinician Data Viewing for Patient Case Appraisal: A Mixed-Methods Study.
Senathirajah Y, Kaufman D, Bakken S. EGEMS (Wash DC). 2016 May 2;4(1):1176. doi: 10.13063/2327-9214.1176. PMID: 27195306

Characterizing and Visualizing Display and Task Fragmentation in the Electronic Health Record: Mixed Methods Design
Y Senathirajah, DR Kaufman, KD Cato, EM Borycki, JA Fawcett, Andre W Kushniruk. JMIR human factors 7 (4), 2020. e18484

Navigation in the electronic health record: A review of the safety and usability literature.
Roman LC, Ancker JS, Johnson SB, Senathirajah Y. J Biomed Inform. 2017 Mar;67:69-79. doi: 10.1016/j.jbi.2017.01.005. PMID: 28088527

The Clinician in the Driver's Seat - Cognition and Interaction in MedWISE.
Senathirajah, Y., Kaufman, D., Bakken, S. AMIA 2012

Architectural and usability considerations in the development of a web 2.0-based EHR.
Senathirajah Y, Bakken S. Stud Health Technol Inform. 2009;143:315-21.

Cognitive analysis of a highly configurable web 2.0 EHR interface.
Senathirajah Y, Kaufman, D., Bakken S. Paper, AMIA Annu Symp Proc. 2010:732-736.

[PDF] Visual Clustering Analysis of CIS Logfiles to Inform Creation of a User-configurable Web 2.0 CIS Interface.
Senathirajah Y, Bakken S. Methods of Information in Medicine. 2010.

Logfile analysis of CIS use to inform creation of a user-configurable widget-based web 2.0 CIS interface: a feasibility study.
Senathirajah Y, Bakken S. Paper, AMIA Annu Symp Proc. 2009.

MedWISE: clinical mashups development.
Senathirajah Y, Bakken S. Poster, AMIA Annu Symp Proc. 2009.

Applying mixed methods to examine usability of a web 2.0-based EHR.
Senathirajah Y, Bakken S. Poster, AMIA Spring Congress 2009. (Practice-based research track).

Development of user-configurable information source pages for medical information retrieval.
Senathirajah Y, Bakken S. AMIA Annu Symp Proc. 2007 Oct 11:1109.PMID: 18694206

Selected Talks

Clinicians in Control. Partners Healthcare

Design and Evaluation of a Widget-based ‘Web 2.0’ Electronic Health Record, Danish National Health IT conference, Nyborg, Denmark, October 2010. MedWISE: a web 2.0-based EHR. Theater-style demonstration, American Medical Informatics Association Annual Meeting, San Francisco, 2009.

Design and Evaluation of a Widget-based ‘Web 2.0’ Electronic Health Record. National Library of Medicine Informatics Training Conference, Denver CO 2010.



For Students


We are a collaborative, multi-disciplinary research team working (and enjoying!) pushing the forefront of interaction design & health information technology. We value creativity, diversity, the desire to work with users or on problems that are important to users and patients. We are inspired by the increasingly friendly environment to innovation in healthcare and we look for others who share our enthusiasm!

Undergraduate and graduate students or those looking for research positions are encouraged to apply. We accept students from many disciplines, including Computer Science, Design, Human Factors, Engineering, Psychology, and all fields of health-related informatics.

Postdoc candidates are encouraged to contact Dr. Senathirajah directly. Please send your CV along with a brief description of your previous research experience and future interests.

Our laboratory prioritizes student development, including support for posters and publications and attendance at national and international conferences. We hope you will consider spending time with us.


For Collaborators


We encourage national and international scientists and developers with shared interests to reach out to us.


For Doctors and Nurses

Opportunities for clinicians.

We welcome nurses, physicians, other types of clinicians, and all types of trainees (resident physicians, interns, etc.) who interested our research. If you would like to hear more about getting involved as a co-investigator, as a research volunteer, or on a consultant basis, we'd like to hear from you.

About Us

Yalini Senathirajah,PhD

Yalini Senathirajah, PhD is Associate Professor, department of biomedical informatics, University of Pittsburgh medical school, and visiting Associate Investigator, Northwell Health. Her research interests include clinical and public health informatics. She has extensive experience with web technologies and the use of technology for health interventions, having served in several research-oriented webmaster positions including five years as webmaster of the Columbia University Health sciences campus (a very large academic medical center), where she created/managed a large consumer-oriented health website and numerous other applications in support of research, education and patient care.

Andre Kushniruk, PhD

Dr. Andre Kushniruk is Director and Professor in Health Informatics at the School of Health Information Science at the University of Victoria in Canada. Dr. Kushniruk conducts research in a number of areas including evaluation of the effects of technology, human-computer interaction in health care and other domains as well as cognitive science. His work is known internationally and he has published widely in the area of health informatics. He focuses on developing new methods for the evaluation of information technology and studying human-computer interaction in health care in studies of both technology designed for healthcare providers and patients. He has been a key researcher on a number of national and international collaborative projects. Dr. Kushniruk has held academic positions at a number of Canadian universities and worked with a number of major hospitals in both Canada and the United States. He holds undergraduate degrees in Psychology and Biology, as well as a M.Sc. in Computer Science from McMaster University and a Ph.D. in Cognitive Psychology from McGill University. He was elected fellow of the American College of Medical Informatics in 2009.

Elizabeth Borycki, RN, PhD

Elizabeth Borycki RN PhD, is the Director of the Social Dimensions of Health program and the Director of the Health and Society program in the Office of Interdisciplinary Academic Programs at the University of Victoria. She is a Professor in the School of Health Information Science at the University of Victoria. Elizabeth joined the University of Victoria 11 years ago. Prior to coming to the University of Victoria, she spent over 15 years working in health care in varying roles as a chronic disease management specialist, acute care geriatric clinical nurse specialist, case manager and clinical informatics specialist. She has published over 150 articles, book chapters and books in health informatics and health care. Elizabeth has served as Academic Representative for Canada for Canada’s Health Informatics Association (2007-2013), Vice President representing North America on the Board of Directors for the International Medical Informatics Association (IMIA) (2010–2013). She founded the International Medical Informatics Association Working Group focusing on Health Informatics for Patient Safety and she is currently the Scientific Program Committee Co-Chair for Medinfo 2017. Elizabeth will return to the Board of Directors of IMIA in August of 2016 as Vice President – Special Projects. Elizabeth received her PhD from the Department of Health Policy, Management and Evaluation in the Faculty of Medicine at the University of Toronto, Canada, a Masters of Nursing from the University of Manitoba in geriatrics and community health nursing and an Honours Bachelor of Science in Nursing from Lakehead University.

Kenrick Cato, PhD, RN, CPHIMS

Kenrick Cato, PhD, RN, CPHIMS, is a Nurse Researcher/Assistant Professor for NewYork-Presbyterian Hospital and Columbia University School of Nursing, respectively. Dr. Cato’s program of research focuses on the use of data science to investigate ways of improving patient safety, quality of care, and individual health. His current projects include automated data mining of electronic patient records to discover characters about a patient that are often missed by clinicians, clinical decision tools to reduce cognitive load and development of predictive models for healthcare associated infections.

Lisette Roman, MS

Lisette Roman, MS joined the Senathirajah Lab while a Masters candidate in health informatics at Weill Cornell Medicine. Her research interests include human factors, quality and safety, and health policy. She enjoys working on health IT problems that stand in the way of efficient, safe, and satisfying delivery of care.

Jetmira Simixhiu, MS

Jetmira Simixhiu, MS is a student of the Medical Informatics Masters Program at SUNY Downstate Medical Center. Her research interests include improving the quality and efficiency of health care through analysis of usage of the electronic health records. She enjoys working in a clinical informatics environment and she believes in bringing a higher level of patient care through improvements in clinicians’ workflow.

Serge Ross, BA

Serge Ross studied Biomedical Informatics at CUNY New York City College of Technology. Interested in improving use of Medical Informatics and Information Technology in healthcare. Currently, full-time dad.

Junbin Sun, MS

Junbin Sun is a Field Researcher at Weill Cornell Medicine and General Manager Of Shandong Province Academy of Engineering Consulting Co., Ltd. Jian Lu Zhi Hua. Junbin received his M.S. in Health Informatics from Cornell University and B.S. in Computer Science from Rensselaer Polytechnic Institute.

Junbin Sun initiated his research at Weill Cornell Medicine with Dr. Sameer Malhotra, the Medical Director of Informatics at the Physician Organization of Weill Cornell Medical College. Currently, he works on the systematic improvement on Clinical Decision Support Systems (CDSS) of the institution's outpatient electronic health record (EHR).

In 2017, he was designated General Manager Of Shandong Province Academy of Engineering Consulting Co., Ltd. Jian Lu Zhi Hua. In Zhihua, Junbin is in charge of engineering consulting; project supervision; economic and trade consulting; tender agent; project management; market research (not engaged in social research); enterprise management consulting; conference services ; short-term non-degree internal management training. During the research , Junbin processed a series of National Patent of China authorized and published. Available from Patent NO: “Dec.25.2013. CN201310423341.5”/ “Dec.11.2013. CN201310424272.X “/ “Feb.26.2014.CN201320576165.4”.

From 2013 to 2015, he was worked for the Algorithmic Trading team at T3 Trading Group, LLC., providing tracking of risk related to strategic trading, Junbin Sun was in charge of controlling the risk of during the trading process. He consulted in designing event driven alert and monitor execution management system prepared for Derrick Oldensmiths, Registered Principal at T3 Trading Group.


Contact Us

Yalini Senathirajah
Associate Professor University of Pittsburgh Medical School Department page
Associate Investigator, Northwell Health

Skype: yalinisen