ArticleJMIR human factors2018
Reducing Misses and Near Misses Related to Multitasking on the Electronic Health Record: Observational Study and Qualitative Analysis.
Article in JMIR human factors, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07742761 (Emergency Medicine Practitioners Overall Well-being Enhancement With Ambient AI Scribes), which is not on this map. Cited by 16 papers.
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.
Emergency Medicine Practitioners Overall Well-being Enhancement With Ambient AI Scribes
Who cites it
16 citing papers in PubMed.
- Utilization of Generative AI-drafted Responses for Managing Patient-Provider Communication.NPJ digital medicine · 2025Article
- Pharmaceutical Analysis of Inpatient Prescriptions: Systematic Observation of Hospital Pharmacists' Practices in the Early User-Centered Design Phase.JMIR human factors · 2025Article
- Measuring cognitive effort using tabular transformer-based language models of electronic health record-based audit log action sequences.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Using electronic health record audit log data for research: insights from early efforts.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Measuring and Maximizing Undivided Attention in the Context of Electronic Health Records.Applied clinical informatics · 2022Article
- Predicting physician burnout using clinical activity logs: Model performance and lessons learned.Journal of biomedical informatics · 2022Article
- Locked the Car, Why Not the Computer: A Qualitative and Quantitative Study on Data Safety Compliance.Cureus · 2021Article
- Conceptual considerations for using EHR-based activity logs to measure clinician burnout and its effects.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Perceptual Gaps Between Clinicians and Technologists on Health Information Technology-Related Errors in Hospitals: Observational Study.JMIR human factors · 2021Article
- Nurses' experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran.BMC medical informatics and decision making · 2020Article
- Protecting healing relationships in the age of electronic health records: report from an international conference.JAMIA open · 2019Article
- Perspectives of English, Chinese, and Spanish-Speaking Safety-Net Patients on Clinician Computer Use: Qualitative Analysis.Journal of medical Internet research · 2019Article
- Data-Driven Scheduling for Improving Patient Efficiency in Ophthalmology Clinics.Ophthalmology · 2019Article
- A Daily Hospital Progress Note that Increases Physician Usability of the Electronic Health Record by Facilitating a Problem-Oriented Approach to the Patient and Reducing Physician Clerical Burden.The Permanente journal · 2019Article
- Yonder: Near misses, cancer communities, binge-eating disorder, and food banks.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Finding Meaning in Medication Reconciliation Using Electronic Health Records: Qualitative Analysis in Safety Net Primary and Specialty Care.JMIR medical informatics · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundClinicians' use of electronic health record (EHR) systems while multitasking may increase the risk of making errors, but silent EHR system use may lower patient satisfaction. Delaying EHR system use until after patient visits may increase clinicians' EHR workload, stress, and burnout.
objectiveWe aimed to describe the perspectives of clinicians, educators, administrators, and researchers about misses and near misses that they felt were related to clinician multitasking while using EHR systems.
methodsThis observational study was a thematic analysis of perspectives elicited from 63 continuing medical education (CME) participants during 2 workshops and 1 interactive lecture about challenges and strategies for relationship-centered communication during clinician EHR system use. The workshop elicited reflection about memorable times when multitasking EHR use was associated with "misses" (errors that were not caught at the time) or "near misses" (mistakes that were caught before leading to errors). We conducted qualitative analysis using an editing analysis style to identify codes and then select representative themes and quotes.
resultsAll workshop participants shared stories of misses or near misses in EHR system ordering and documentation or patient-clinician communication, wondering about "misses we don't even know about." Risk factors included the computer's position, EHR system usability, note content and style, information overload, problematic workflows, systems issues, and provider and patient communication behaviors and expectations. Strategies to reduce multitasking EHR system misses included clinician transparency when needing silent EHR system use (eg, for prescribing), narrating EHR system use, patient activation during EHR system use, adapting visit organization and workflow, improving EHR system design, and improving team support and systems.
conclusionsCME participants shared numerous stories of errors and near misses in EHR tasks and communication that they felt related to EHR multitasking. However, they brainstormed diverse strategies for using EHR systems safely while preserving patient relationships.
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