Observational studyHealth information management : journal of the Health Information Management Association of Australia2021
Analysing EHR navigation patterns and digital workflows among physicians during ICU pre-rounds.
Observational study in Health information management : journal of the Health Information Management Association of Australia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Challenges in Identifying Heart Failure Diagnoses from the Electronic Health Record.Journal of cardiac failure - intersections · 2026Article
- Patient Experiences with Virtual Nursing: A Qualitative Survey.Studies in health technology and informatics · 2025Article
- Multimodal artificial intelligence in medicine: a task-oriented framework for clinical translation.Frontiers in medicine · 2025Review
- Examining Pediatric Resident Electronic Health Records Use During Prerounding: Mixed Methods Observational Study.JMIR medical education · 2023Article
- An integrative review of supportive relationships between child-bearing women and midwives.Nursing open · 2023Review
- Inferring EHR Utilization Workflows through Audit Logs.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2022Article
- Association between ICU interruptions and physicians trainees' electronic health records efficiency.Informatics for health & social care · 2021Article
- Association Between Proficiency and Efficiency in Electronic Health Records Among Pediatricians at a Major Academic Health System.Frontiers in digital health · 2021Article
- EMR Precharting Efficiency in Internal Medicine: A Scoping Review.Journal of medical education and curricular developmentArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundSome physicians in intensive care units (ICUs) report that electronic health records (EHRs) can be cumbersome and disruptive to workflow. There are significant gaps in our understanding of the physician-EHR interaction.
objectiveTo better understand how clinicians use the EHR for chart review during ICU pre-rounds through the characterisation and description of screen navigation pathways and workflow patterns.
methodWe conducted a live, direct observational study of six physician trainees performing electronic chart review during daily pre-rounds in the 30-bed medical ICU at a large academic medical centre in the Southeastern United States. A tailored checklist was used by observers for data collection.
resultsWe observed 52 distinct live patient chart review encounters, capturing a total of 2.7 hours of pre-rounding chart review activity by six individual physicians. Physicians reviewed an average of 8.7 patients (range = 5-12), spending a mean of 3:05 minutes per patient (range = 1:34-5:18). On average, physicians visited 6.3 (±3.1) total EHR screens per patient (range = 1-16). Four unique screens were viewed most commonly, accounting for over half (52.7%) of all screen visits: results review (17.9%), summary/overview (13.0%), flowsheet (12.7%), and the chart review tab (9.1%). Navigation pathways were highly variable, but several common screen transition patterns emerged across users. Average interrater reliability for the paired EHR observation was 80.0%.
conclusionWe observed the physician-EHR interaction during ICU pre-rounds to be brief and highly focused. Although we observed a high degree of "information sprawl" in physicians' digital navigation, we also identified common launch points for electronic chart review, key high-traffic screens and common screen transition patterns. IMPLICATIONS: From the study findings, we suggest recommendations towards improved EHR design.
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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.