ArticleApplied clinical informatics2017
Health IT Usability Focus Section: Data Use and Navigation Patterns among Medical ICU Clinicians during Electronic Chart Review.
Article in Applied clinical informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Clinicians' reasoning as reflected in electronic clinical note-entry and reading/retrieval: a systematic review and qualitative synthesis.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- A Novel Electronic Medical Record Search Method to Identify Patients With Ketosis-Prone Diabetes: Implications for Discovery of Atypical Diabetes.Diabetes care · 2026Article
- Information Prioritization and Reading Patterns in Electronic Health Record Nursing Summaries: An Eye-Tracking Case Study.Applied clinical informatics · 2025Article
- Usability Challenges in Electronic Health Records: Impact on Documentation Burden and Clinical Workflow: A Scoping Review.Journal of evaluation in clinical practice · 2025Article
- Medical Marijuana Documentation Practices in Patient Electronic Health Records: Retrospective Observational Study Using Smart Data Elements and a Review of Medical Records.JMIR formative research · 2024Observational
- Who needs clinician attention first? A qualitative study of critical care clinicians' needs that enable the prioritization of care for populations of acutely ill patients.International journal of medical informatics · 2023Article
- Involving Health Care Professionals in the Development of Electronic Health Records: Scoping Review.JMIR human factors · 2023Article
- Information and Data Visualization Needs among Direct Care Nurses in the Intensive Care Unit.Applied clinical informatics · 2022Article
- Investigating the cognitive capacity constraints of an ICU care team using a systems engineering approach.BMC anesthesiology · 2022Article
- Association between ICU interruptions and physicians trainees' electronic health records efficiency.Informatics for health & social care · 2021Article
- Analysing EHR navigation patterns and digital workflows among physicians during ICU pre-rounds.Health information management : journal of the Health Information Management Association of Australia · 2021Observational
- Classification of Electronic Health Record-Related Patient Safety Incidents: Development and Validation Study.JMIR medical informatics · 2021Article
- Article
- User-Centered Clinical Display Design Issues for Inpatient Providers.Applied clinical informatics · 2020Article
- Assessment of Electronic Health Record Search Patterns and Practices by Practitioners in a Large Integrated Health Care System.JAMA network open · 2020Article
- Impact of Patient Census and Admission Mortality on Pediatric Intensive Care Unit Attending Electronic Health Record Activity: A Preliminary Study.Applied clinical informatics · 2020Article
- Using machine learning to selectively highlight patient information.Journal of biomedical informatics · 2019Article
- Unintended Consequences of Nationwide Electronic Health Record Adoption: Challenges and Opportunities in the Post-Meaningful Use Era.Journal of medical Internet research · 2019Article
- Building Usability Knowledge for Health Information Technology: A Usability-Oriented Analysis of Incident Reports.Applied clinical informatics · 2019Article
- Data Omission by Physician Trainees on ICU Rounds.Critical care medicine · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background A detailed understanding of electronic health record (EHR) workflow patterns and information use is necessary to inform user-centered design of critical care information systems. While developing a longitudinal medical record visualization tool to facilitate electronic chart review (ECR) for medical intensive care unit (MICU) clinicians, we found inadequate research on clinician–EHR interactions. Objective We systematically studied EHR information use and workflow among MICU clinicians to determine the optimal selection and display of core data for a revised EHR interface. Methods We conducted a direct observational study of MICU clinicians performing ECR for unfamiliar patients during their routine daily practice at an academic medical center. Using a customized manual data collection instrument, we unobtrusively recorded the content and sequence of EHR data reviewed by clinicians. Results We performed 32 ECR observations among 24 clinicians. The median (interquartile range [IQR]) chart review duration was 9.2 (7.3–14.7) minutes, with the largest time spent reviewing clinical notes (44.4%), laboratories (13.3%), imaging studies (11.7%), and searching/scrolling (9.4%). Historical vital sign and intake/output data were never viewed in 31% and 59% of observations, respectively. Clinical notes and diagnostic reports were browsed ≥10 years in time for 60% of ECR sessions. Clinicians viewed a median of 7 clinical notes, 2.5 imaging studies, and 1.5 diagnostic studies, typically referencing a select few subtypes. Clinicians browsed a median (IQR) of 26.5 (22.5–37.25) data screens to complete their ECR, demonstrating high variability in navigation patterns and frequent back-and-forth switching between screens. Nonetheless, 47% of ECRs begin with review of clinical notes, which were also the most common navigation destination. Conclusion Electronic chart review centers around the viewing of clinical notes among MICU clinicians. Convoluted workflows and prolonged searching activities indicate room for system improvement. Using study findings, specific design recommendations to enhance usability for critical care information systems are provided.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.