ArticleJournal of general internal medicine2009
Primary care physicians' use of an electronic medical record system: a cognitive task analysis.
Article in Journal of general internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 7 of them syntheses that pooled it.
What it found
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Who cites it
59 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Safety and usability of oncology information systems - a systematic review.Frontiers in oncology · 2024Pooled it
- Examining Mental Workload Relating to Digital Health Technologies in Health Care: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Factors affecting the mature use of electronic medical records by primary care physicians: a systematic review.BMC medical informatics and decision making · 2021Pooled it
- Primary care physicians' attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework.BMC medical informatics and decision making · 2018Pooled it
- Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions.BMC health services research · 2010Pooled it
- Challenges and Opportunities for Health Information Systems in Primary Care Clinics: A Mixed-Method Study among Health Workers in Manila, Philippines.Applied clinical informatics · 2025Article
- AI-powered precision medicine: utilizing genetic risk factor optimization to revolutionize healthcare.NAR genomics and bioinformatics · 2025Review
- Article
- A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study.Nursing open · 2024Article
- Real world challenges in maintaining data integrity in electronic health records in a cancer program.Technical innovations & patient support in radiation oncology · 2024Article
- "What brought you in today?": Modeling patient-provider clinic visits to characterize rural providers' antibiotic treatment decisions.Research in social & administrative pharmacy : RSAP · 2023Article
- Physicians' Perspectives on a Multi-Dimensional Model for the Roles of Electronic Health Records in Approaching a Proper Differential Diagnosis.Journal of personalized medicine · 2023Article
- Applying cognitive task analysis to health services research.Health services research · 2023Article
- The Integrated Electronic Health System in Iranian health centers: benefits and challenges.BMC primary care · 2023Article
- Digital technology in medical visits: a critical review of its impact on doctor-patient communication.Frontiers in psychiatry · 2023Review
- Do nurses document all discussions of patient problems and nursing interventions in the electronic health record? A pilot study in home healthcare.JAMIA open · 2022Article
- Utilizing a cognitive engineering approach to conduct a hierarchical task analysis to understand complex older adult decision-making during over-the-counter medication selection.Research in social & administrative pharmacy : RSAP · 2021Article
- How Do Patients Want Us to Use the Computer During Medical Encounters?-A Discrete Choice Experiment Study.Journal of general internal medicine · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe physicians' patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient-doctor communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular.
designCognitive task analysis using semi-structured interviews and field observations.
participantsTwenty-five primary care physicians from the northern district of the largest health maintenance organization (HMO) in Israel.
resultsThe comprehensiveness, organization, and readability of data in the EMR system reduced physicians' need to recall information from memory and the difficulty of reading handwriting. Physicians perceived EMR use as reducing the cognitive load associated with clinical tasks. Automaticity of EMR use contributed to efficiency, but sometimes resulted in errors, such as the selection of incorrect medication or the input of data into the wrong patient's chart. EMR use interfered with patient-doctor communication. The main strategy for overcoming this problem involved separating EMR use from time spent communicating with patients. Computer mastery and enhanced physicians' communication skills also helped.
conclusionsThere is a fine balance between the benefits and risks of EMR use. Automaticity, especially in combination with interruptions, emerged as the main cognitive factor contributing to errors. EMR use had a negative influence on communication, a problem that can be partially addressed by improving the spatial organization of physicians' offices and by enhancing physicians' computer and communication skills.
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