Using High-Fidelity Simulation and Eye Tracking to Characterize EHR Workflow Patterns among Hospital Physicians.

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Medical Education

Background:

• Electronic Health Records (EHRs) are complex systems with variable user training and behavior.
• Efficient access to clinical data within EHRs is crucial for patient safety.
• Understanding physician EHR usage is essential for optimizing system design and clinical workflows.

Purpose of the Study:

• To characterize typical EHR usage patterns among hospital physicians (hospitalists) when encountering a new patient.
• To identify similarities and differences in information access and documentation workflows.
• To inform EHR interface design and future usability research.

Main Methods:

• A mixed-methods approach was utilized.
• A high-fidelity EHR simulation environment was employed.
• Eye-tracking, screen tracking, surveys, and semi-structured interviews were conducted with hospital physicians.

Main Results:

• Physicians demonstrated consistent patterns in frequently accessed information types.
• Two distinct workflow types emerged for EHR data gathering and note creation, despite no difference in overall case duration.
• Note composition constituted the majority of time spent within the EHR for all participants.

Conclusions:

• Despite common information needs, individual physician EHR workflows vary significantly.
• The substantial time dedicated to note composition highlights potential areas for EHR interface optimization.
• Further research is needed to explore the diversity of individual user workflows within EHR systems.