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Related Experiment Videos

Human and system errors, using adaptive turnaround documents to capture data in a busy practice.

Stephen M Downs1, Aaron E Carroll, Vibha Anand

  • 1Children's Health Services Research, Indiana University School of Medicine and Regenstrief Institute, Inc., Indianapolis, IN, USA.

AMIA ... Annual Symposium Proceedings. AMIA Symposium
|June 17, 2006
PubMed
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Adaptive turnaround documents (ATDs) effectively capture coded clinical data from physicians with minimal workflow disruption. While physician errors were low (1.8%), system errors (7.2%) highlight the need for improved scanning automation.

Area of Science:

  • Clinical Informatics
  • Health Services Research
  • Medical Decision Support

Background:

  • Clinical decision support systems (CDSS) improve patient care but face implementation barriers due to cost and workflow disruption.
  • Adaptive turnaround documents (ATDs) offer a low-cost, minimally disruptive alternative for capturing coded clinical data.
  • Previous studies confirmed ATD accuracy in controlled settings, but real-world clinical accuracy with physician users was unverified.

Purpose of the Study:

  • To evaluate the accuracy and error rates of an ATD system implemented in busy clinical settings.
  • To identify sources of errors, distinguishing between physician user errors and system-related errors.
  • To assess the feasibility of ATDs for routine clinical data capture.

Main Methods:

Related Experiment Videos

  • A new ATD system was developed and implemented in clinical practice.
  • Physician user errors and system errors were systematically tracked during patient encounters.
  • Error rates were calculated based on the percentage of prompts used (63% of encounters).

    • Main Results:

    • Physician errors in marking forms occurred in 1.8% of prompts.
    • System errors were observed in 7.2% of prompts, primarily due to data capture failures.
    • The majority of system errors likely stemmed from human error during the scanning process.

    Conclusions:

    • ATDs provide an effective method for physicians to collect coded clinical data, supporting clinical decision making.
    • Minimizing system errors, particularly those related to scanning, can further enhance ATD utility.
    • Further automation of the scanning process holds potential to reduce system errors and improve overall efficiency.