Emergency medicine resident physicians' perceptions of electronic documentation and workflow: a mixed methods study

Area of Science:

• Medical Informatics
• Human-Computer Interaction
• Emergency Medicine

Background:

• Electronic documentation is integral to emergency department (ED) operations.
• Optimizing electronic health record (EHR) systems requires understanding physician usage patterns and challenges.

Purpose of the Study:

• To investigate emergency department physicians' electronic documentation practices.
• To identify usability and workflow considerations for designing future ED information system (EDIS) physician documentation modules.

Main Methods:

• Mixed-methods study involving task analysis and qualitative interviews with emergency medicine resident physicians.
• Simulated standardized patient encounters were used to observe electronic documentation within a test EDIS environment.
• Qualitative data were analyzed using the constant comparative method.

Main Results:

• Physicians spent an average of 11 minutes on electronic documentation during a 17-minute simulation.
• Observed workflows varied among participants, with some performing documentation tasks in parallel with patient care.
• Key themes included variable documentation timing based on patient acuity, a need for efficiency-enhancing features, and difficulties integrating EDIS with other data sources.

Conclusions:

• Physicians dedicate substantial time to documentation during ED visits.
• Resident physicians exhibit diverse workflows, necessitating flexible EHR design.
• Future EHR development should prioritize workflow optimization and seamless data integration.