EHR perception and momentary well-being in oncology professionals

Digital systems increasingly shape oncology workflows, yet their impact on professionals' momentary well-being remains poorly understood. Existing evidence relies on retrospective self-reports and lacks real-time, multimodal data. We examined whether momentary perception of an oncology electronic health record (EHR), differentiated into instrumental quality (e.g. usability) and noninstrumental quality (e.g. visual esthetics), relates to oncology professionals' concurrent psychophysiological well-being during routine clinical use.

In this multimodal ambulatory assessment study at a German tertiary university hospital, 22 oncology professionals provided 449 momentary self-report assessments during active EHR interaction. System perception, positive and negative affect, and acute stress were assessed at each prompt. Continuous electrocardiography was recorded in 18 participants (342 observations), from which heart rate variability (HRV) was derived for the 5-min window preceding each prompt. Multilevel regression models separated within- from between-person effects.

Both instrumental and noninstrumental quality independently predicted overall EHR system appraisal. The two dimensions showed distinct associations with momentary well-being: at the within-person level, higher instrumental quality was associated with more positive affect (β = 0.08, P = 0.012), less negative affect (β = -0.10, P = 0.014), and marginally lower acute stress (β = -0.06, P = 0.083). Higher noninstrumental quality was linked to higher HRV (β = 0.12, P = 0.002).

Momentary EHR system perception is associated with multiple facets of psychophysiological well-being during routine oncology workflows. As sustainable cancer care depends on the well-being of oncology professionals, clinical software emerges as a design-accessible correlate relevant to system sustainability.