Information Distortion in Electronic Health Records: A Concept Analysis

Area of Science:

• Health Informatics
• Medical Documentation
• Healthcare Quality Improvement

Background:

• Information distortion within Electronic Health Records (EHRs) presents a significant challenge in modern healthcare.
• Accurate and reliable health information is crucial for effective patient care and clinical decision-making.

Purpose of the Study:

• To conceptualize information distortion in EHRs.
• To establish a theoretical framework for enhancing healthcare documentation practices.

Main Methods:

• A rigorous concept analysis was performed using Walker and Avant's strategy.
• A comprehensive literature search was conducted across major databases (PubMed, Web of Science, Embase, CINAHL, Scopus) up to December 2024.
• Thirty-seven studies addressing information distortion in EHRs were included in the analysis.

Main Results:

• Three defining attributes of information distortion were identified: real-world health truth, representation of reality, and mismatch relationship.
• Antecedents were categorized into five groups: people-related, equipment, regulatory, working environment, and management factors.
• Consequences include threats to patient safety, diminished operational performance, eroded trust, compromised research integrity, and health inequities.

Conclusions:

• This concept analysis deepens the understanding of information distortion in EHRs, offering a basis for empirical validation.
• Findings can inform the development of measurement tools and strategies to mitigate EHR information distortion in clinical settings.
• Improved conceptual clarity aids in analyzing flawed EHR documentation and its systemic impact on healthcare.