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Related Experiment Video

Updated: May 23, 2026

The Immersive Cleveland Clinic Virtual Reality Shopping Platform for the Assessment of Instrumental Activities of Daily Living

The Immersive Cleveland Clinic Virtual Reality Shopping Platform for the Assessment of Instrumental Activities of Daily Living

Published on: July 28, 2022

Guided ordering: clinician interactions with complex order-sets.

Daniel Shine¹, Himali Weerahandi, Katherine Hochman

¹Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA. daniel.shine@nyumc.org

International Journal of Medical Informatics

|April 13, 2012

Summary

This summary is machine-generated.

Clinicians often provide inaccurate responses to electronic order-set questions, with 75% admitting intentional inaccuracy due to perceived irrelevance, impacting clinical decision-making.

Related Experiment Videos

Last Updated: May 23, 2026

The Immersive Cleveland Clinic Virtual Reality Shopping Platform for the Assessment of Instrumental Activities of Daily Living

The Immersive Cleveland Clinic Virtual Reality Shopping Platform for the Assessment of Instrumental Activities of Daily Living

Published on: July 28, 2022

Area of Science:

Medical Informatics
Clinical Decision Support
Health Services Research

Background:

Electronic order-sets frequently prompt clinicians with questions or algorithms.
Clinician cooperation with these embedded prompts has not been previously studied.

Purpose of the Study:

To investigate the accuracy of clinician responses to embedded questions within electronic admission and discharge order-sets.
To determine the reasons behind clinician responses to mandatory order-set prompts.

Main Methods:

Review of 180 electronic medical records from an academic medical center's Internal Medicine service.
Analysis of clinician responses against clinical evidence, diagnosis coding, and admitting physician's documented belief.
Anonymous survey of clinicians regarding their practices and rationale for answering embedded questions.

Main Results:

A significant discordance was observed between clinician responses and clinical evidence, particularly negative responses on admission despite supporting documentation.
75% of surveyed clinicians admitted to intentionally providing inaccurate answers.
The primary reason cited for inaccuracy was the perceived irrelevance of the question to the current clinical situation.

Conclusions:

Clinician non-adherence to embedded order-set questions may stem from order-set design flaws, software limitations, or resistance to directed workflows.
The study highlights potential issues with the implementation and design of clinical decision support tools within electronic health records.