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Analysing EHR navigation patterns and digital workflows among physicians during ICU pre-rounds.

Cameron Coleman1, David Gotz1, Samantha Eaker1

  • 1University of North Carolina at Chapel Hill, USA.

Health Information Management : Journal of the Health Information Management Association of Australia
|June 2, 2020
PubMed
Summary
This summary is machine-generated.

Physicians using electronic health records (EHRs) in the ICU during pre-rounds navigate numerous screens briefly. Understanding these physician-EHR interactions can inform improved EHR design for critical care settings.

Keywords:
ICUclinical workelectronic health records (EHR)health information managementworkflow

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Area of Science:

  • Medical Informatics
  • Clinical Workflow Analysis
  • Human-Computer Interaction in Healthcare

Background:

  • Physicians in intensive care units (ICUs) report electronic health records (EHRs) can be cumbersome and disruptive.
  • Understanding the physician-EHR interaction is crucial for optimizing clinical workflows.

Purpose of the Study:

  • To characterize screen navigation pathways and workflow patterns during ICU pre-rounds.
  • To describe how clinicians utilize EHRs for chart review in the ICU setting.

Main Methods:

  • Direct observational study of six physician trainees in a medical ICU.
  • Data collection using a tailored checklist during live patient chart review.
  • Analysis of screen navigation and workflow patterns during pre-rounding activities.

Main Results:

  • Observed 52 chart review encounters totaling 2.7 hours.
  • Physicians reviewed an average of 8.7 patients per session, spending approximately 3 minutes per patient.
  • Commonly viewed screens included results review, summary/overview, flowsheets, and chart review tabs, with highly variable navigation pathways.

Conclusions:

  • Physician-EHR interaction during ICU pre-rounds is brief and focused.
  • Identified common EHR launch points, high-traffic screens, and navigation patterns despite "information sprawl."
  • Findings suggest recommendations for improved EHR design to enhance usability in critical care.