Related Experiment Video
Updated: May 24, 2026
03:47
Workflow and Framework for Collecting and Implementing Point-of-Care Ultrasound Data in the Management of Heart Failure Patients
Published on: July 12, 2024
From interface to outcome: a 4I framework for AI-linked functionality in electronic health records
Ting Zhang1,2, Nina Shin3
1College of Business and Economics, Sejong University, Gwangjin-gu, Seoul, Republic of Korea.
BMC Medical Informatics and Decision Making
|May 23, 2026
Summary
This review synthesizes evidence on electronic health records (EHRs) and AI, revealing how interface and information design impact clinician interaction and outcomes. The 4I framework aids in understanding these complex relationships for better EHR development.
Area of Science:
- Medical Informatics
- Human-Computer Interaction
- Health Systems Research
Background:
- Electronic Health Records (EHRs) face persistent socio-technical challenges impacting usability and clinician burden.
- EHRs are increasingly integrating AI and decision support, expanding the scope of research.
- Existing studies often obscure the links between EHR design, user experience, and outcomes.
Purpose of the Study:
- To systematically review and synthesize research on EHR design and use, including AI-linked functionalities.
- To establish traceable links between EHR interface/information conditions and clinician interaction/outcomes.
- To develop a framework for clearer reporting and interpretation of EHR-related evidence.
Main Methods:
- An integrative literature review of 70 studies (2005-2025) on EHR design, use, and AI functionalities.
- Synthesis using a four-layer socio-technical architecture: Interface, Information, Interaction, and Outcome (4I).
- Development of 29 evidence-traceable variables to characterize factors facilitating or constraining EHR adoption and use.
Main Results:
- Interface and information variables significantly influence interaction experiences like workflow fit and cognitive workload.
- Favorable EHR adoption is associated with reliable performance, interpretable outputs, training, and organizational support.
- Downstream effects linked to EHR use include documentation burden, burnout, patient safety risks, and decision-making augmentation.
Conclusions:
- The 4I framework offers a structured approach to synthesize EHR evidence, including AI functionalities, with explicit outcome considerations.
- A 29-variable dictionary enhances reporting clarity and cross-layer interpretation for EHR research.
- This framework provides a foundation for future research and empirical assessment of AI-linked EHR functions.
Related Concept Videos
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:20Integrated Healthcare System
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
01:19Purpose of Health Records II
Health records serve various essential purposes in the healthcare system. Here are some key purposes:
01:27Nursing Clinical Information System
Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:21Methods of Documentation III: PIE
Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations: