Knowledge crystallization and clinical priorities: evaluating how physicians collect and synthesize patient-related...

Information seeking and synthesis are time consuming processes for physicians. Although systems have the potential to simplify these tasks, future improvements must be based on an understanding of how physicians perform these tasks during clinical prioritization. We enrolled 23 physicians in semi-structured focus groups discussing simulated inpatient populations. Participants documented and discussed their data gathering and prioritization processes. Transcripts were coded to identify themes and generalized process flows. Results indicate that data are collected to categorize and prioritize patients according to expected clinical course. When data do not support these expectations, or when categorization indicates potential for morbidity, physicians increase efforts to act or recategorize patients. Unexpected clinical changes have a significant impact on the decision-making and prioritization by clinicians. A modified version of the Knowledge Crystallization Framework helps to frame this work laying a foundation to advance information displays and facilitate information processing by physicians in clinical care environments.