ArticleJournal of the American Medical Informatics Association : JAMIA2023
Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.
Article in Journal of the American Medical Informatics Association : JAMIA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Evidence on artificial intelligence-assisted clinical documentation and healthcare workers' emotional wellbeing at work: a scoping review.Frontiers in psychology · 2026Pooled it
- Pooled it
- User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.Applied clinical informatics · 2025Trial
- Effects of electronic health records implementation on workflow and health care provider outcomes: a prospective, multi-professional cohort study.JAMIA open · 2026Article
- A lifecycle governance and learning health system framework for trustworthy, generalizable, and sustainable human-ai partnership in clinical practice: Lessons from the asthma-guidance and prediction system (A-GPS).Journal of the National Medical Association · 2026Review
- Large language model-generated clinical summaries in emergency departments: A blinded comparison study.PLOS digital health · 2026Article
- Large Language Model Automated Extraction of Clinical Signs and Symptoms From Emergency Department Reports for Machine Learning Prediction Models: Development and Validation Study.JMIR medical informatics · 2026Article
- Development of a digital tool to support overview in complex patient cases: Which information elements support the clinical workflow?BMC health services research · 2026Article
- A Two-Level, Multidimensional Framework for Understanding and Treating Clinician Fatigue.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Integrated Multidisciplinary and Digital Innovation in Polytrauma: Optimizing Whole-Process Emergency Models for Secondary Hospitals.Open access emergency medicine : OAEM · 2026Review
- Incompleteness of Electronic Health Records: An Impending Process Problem Within Healthcare.Healthcare (Basel, Switzerland) · 2025Article
- AI-generated neurology consultation summaries improve efficiency and reduce documentation burden in the emergency department.Scientific reports · 2025Article
- Behavioral Phenotypes in Electronic Health Record Use by Primary Care Providers: a Cluster Analysis.Journal of general internal medicine · 2025Article
- Evaluating Clinical Staff Perceptions of EHR Usability, Satisfaction, and Adaptation to a New EHR: A Multisite, Pre-Post Implementation Study.Applied clinical informatics · 2025Article
- Choosing between Patient Care Needs and Accurate Data Capture: Exploring Nurses' Experiences of Excessive Documentation Burden.Applied clinical informatics · 2025Article
- Clinical Decision-Making and Use of Clinical Decision Support When Clinicians are Fatigued in an Emergency Department: A Qualitative Study.Applied clinical informatics · 2025Article
- Health Information Systems' Support for Management and Changing Work: Survey Study Among Physicians.JMIR medical informatics · 2025Article
- Analyzing Physician In Basket Burden and Efficiency Using K-Means Clustering.Applied clinical informatics · 2025Article
- Addressing Bureaucratic Burdens on the Portuguese National Health Service: A Simplification Experience Aiming for Value-Based Healthcare.Healthcare (Basel, Switzerland) · 2025Article
- "Everything is electronic health record-driven": the role of the electronic health record in the emergency department diagnostic process.JAMIA open · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveUnderstand the perceived role of electronic health records (EHR) and workflow fragmentation on clinician documentation burden in the emergency department (ED).
methodsFrom February to June 2022, we conducted semistructured interviews among a national sample of US prescribing providers and registered nurses who actively practice in the adult ED setting and use Epic Systems' EHR. We recruited participants through professional listservs, social media, and email invitations sent to healthcare professionals. We analyzed interview transcripts using inductive thematic analysis and interviewed participants until we achieved thematic saturation. We finalized themes through a consensus-building process.
resultsWe conducted interviews with 12 prescribing providers and 12 registered nurses. Six themes were identified related to EHR factors perceived to contribute to documentation burden including lack of advanced EHR capabilities, absence of EHR optimization for clinicians, poor user interface design, hindered communication, increased manual work, and added workflow blockages, and five themes associated with cognitive load. Two themes emerged in the relationship between workflow fragmentation and EHR documentation burden: underlying sources and adverse consequences. DISCUSSION: Obtaining further stakeholder input and consensus is essential to determine whether these perceived burdensome EHR factors could be extended to broader contexts and addressed through optimizing existing EHR systems alone or through a broad overhaul of the EHR's architecture and primary purpose.
conclusionWhile most clinicians perceived that the EHR added value to patient care and care quality, our findings underscore the importance of designing EHRs that are in harmony with ED clinical workflows to alleviate the clinician documentation burden.
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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.