Doberne Julie W, He Ze, Mohan Vishnu, Gold Jeffrey A, Marquard Jenna, Chiang Michael F
Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR.
University of Massachusetts Amherst, Amherst, MA.
AMIA Annu Symp Proc. 2015 Nov 5;2015:1881-9. eCollection 2015.
Modern EHR systems are complex, and end-user behavior and training are highly variable. The need for clinicians to access key clinical data is a critical patient safety issue. This study used a mixed methods approach employing a high-fidelity EHR simulation environment, eye and screen tracking, surveys, and semi-structured interviews to characterize typical EHR usage by hospital physicians (hospitalists) as they encounter a new patient. The main findings were: 1) There were strong similarities across the groups in the information types the physicians looked at most frequently, 2) While there was no overall difference in case duration between the groups, we observed two distinct workflow types between the groups with respect to gathering information in the EHR and creating a note, and 3) A majority of the case time was devoted to note composition in both groups. This has implications for EHR interface design and raises further questions about what individual user workflows exist in the EHR.
现代电子健康记录（EHR）系统很复杂，终端用户的行为和培训情况差异很大。临床医生获取关键临床数据的需求是一个至关重要的患者安全问题。本研究采用了混合方法，运用高保真EHR模拟环境、眼动和屏幕跟踪、调查以及半结构化访谈，来描述医院医生（住院医师）在接诊新患者时使用EHR的典型情况。主要研究结果如下：1）各小组医生最常查看的信息类型有很强的相似性；2）虽然各小组之间病例持续时间没有总体差异，但在EHR中收集信息和撰写记录方面，我们观察到各小组之间存在两种不同的工作流程类型；3）两个小组中大部分病例时间都用于记录撰写。这对EHR界面设计有影响，并引发了关于EHR中存在哪些个体用户工作流程的进一步问题。
