ArticleBMC medical informatics and decision making2015
A qualitative evaluation of the crucial attributes of contextual information necessary in EHR design to support patient-centered medical home care.
Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
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- Electronic Health Records' Support for Primary Care Physicians' Situation Awareness: A Metanarrative Review.Human factors · 2023Review
- Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference.Journal of the American Medical Directors Association · 2022Article
- Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference.Journal of the American Geriatrics Society · 2022Article
- Risk Factors Associated With Nonfatal Opioid Overdose Leading to Intensive Care Unit Admission: A Cross-sectional Study.JMIR medical informatics · 2021Article
- Impacts of Operational Failures on Primary Care Physicians' Work: A Critical Interpretive Synthesis of the Literature.Annals of family medicine · 2020Review
- Detecting Social and Behavioral Determinants of Health with Structured and Free-Text Clinical Data.Applied clinical informatics · 2020Article
- Longitudinal analysis of social and behavioral determinants of health in the EHR: exploring the impact of patient trajectories and documentation practices.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2019Article
- The role of medical data in efficient patient care delivery: a review.Risk management and healthcare policy · 2019Review
- Documenting Routinely What Matters to People: Standardized Headings for Health Records of Patients with Chronic Health Conditions.Applied clinical informatics · 2018Article
- Information needs of physicians, care coordinators, and families to support care coordination of children and youth with special health care needs (CYSHCN).Journal of the American Medical Informatics Association : JAMIA · 2017Article
- Pragmatic trials and improving long-term care: Recommendations from a national institutes of health conference.Geriatric nursing (New York, N.Y.)Article
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Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundEffective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients' contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians' perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas.
methodsA qualitative design using Cognitive Task Analyses and a modified Critical Incident Technique were used. The study was conducted in a large VA with a fully implemented EHR located in the western United States. Seventeen providers working in a PCMH model of care in Primary Care, Home Based Care and Geriatrics reported on a recent difficult transition requiring contextual information for decision-making. The transcribed interviews were qualitatively analyzed for thematic development related to contextual information using an iterative process and multiple reviewers with ATLAS@ti software.
resultsSix overarching themes emerged as attributes of contextual information: Informativeness, goal language, temporality, source attribution, retrieval effort, and information quality.
conclusionsThese results indicate that specific attributes are needed to in order for contextual information to fully support clinical decision-making in a Medical Home care delivery environment. Improved EHR designs are needed for ease of contextual information access, displaying linkages across time and settings, and explicit linkages to both clinician and patient goals. Implications relevant to providers' information needs, team functioning and EHR design are discussed.
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