ArticleJMIR human factors2020
Characterizing and Visualizing Display and Task Fragmentation in the Electronic Health Record: Mixed Methods Design.
Article in JMIR human factors, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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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
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Visual communication of public health data: a scoping review.Frontiers in digital health · 2025Pooled it
- Development of a digital tool to support overview in complex patient cases: Which information elements support the clinical workflow?BMC health services research · 2026Article
- Meeting the challenges of electronic health record (EHR) optimization.NPJ digital medicine · 2025Review
- 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
- Enhancing Care Coordination in Oncology and Nononcology Thoracic Surgery Care Pathways Through a Digital Health Solution: Mixed Methods Study.JMIR formative research · 2024Article
- Generative AI Demonstrated Difficulty Reasoning on Nursing Flowsheet Data.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Identifying and Addressing Barriers to Implementing Core Electronic Health Record Use Metrics for Ambulatory Care: Virtual Consensus Conference Proceedings.Applied clinical informatics · 2023Article
- Involving Health Care Professionals in the Development of Electronic Health Records: Scoping Review.JMIR human factors · 2023Article
- Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Dashboard Design to Identify and Balance Competing Risk of Multiple Hospital-Acquired Conditions.Applied clinical informatics · 2022Article
- Electronic Medical Records for (Visceral) Medicine: An Overview of the Current Status and Prospects.Visceral medicine · 2021Review
- Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study.Children (Basel, Switzerland) · 2021Article
- Classification of Electronic Health Record-Related Patient Safety Incidents: Development and Validation Study.JMIR medical informatics · 2021Article
- Participatory Design of an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Study with Nurses and Physicians.Children (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe complexity of health care data and workflow presents challenges to the study of usability in electronic health records (EHRs). Display fragmentation refers to the distribution of relevant data across different screens or otherwise far apart, requiring complex navigation for the user's workflow. Task and information fragmentation also contribute to cognitive burden.
objectiveThis study aims to define and analyze some of the main sources of fragmentation in EHR user interfaces (UIs); discuss relevant theoretical, historical, and practical considerations; and use granular microanalytic methods and visualization techniques to help us understand the nature of fragmentation and opportunities for EHR optimization or redesign.
methodsSunburst visualizations capture the EHR navigation structure, showing levels and sublevels of the navigation tree, allowing calculation of a new measure, the Display Fragmentation Index. Time belt visualizations present the sequences of subtasks and allow calculation of proportion per instance, a measure that quantifies task fragmentation. These measures can be used separately or in conjunction to compare EHRs as well as tasks and subtasks in workflows and identify opportunities for reductions in steps and fragmentation. We present an example use of the methods for comparison of 2 different EHR interfaces (commercial and composable) in which subjects apprehend the same patient case.
resultsScreen transitions were substantially reduced for the composable interface (from 43 to 14), whereas clicks (including scrolling) remained similar.
conclusionsThese methods can aid in our understanding of UI needs under complex conditions and tasks to optimize EHR workflows and redesign.
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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.