title: Data acquisition behaviors during inpatient results review: implications for problem-oriented data displays.
abstract: Problem-oriented electronic medical records may have significant advantages over source-oriented organization of patient data. However, reorganizing data in this fashion may have unexpected consequences for the clinical decision-making process. To determine what these consequences might be, we conducted a pilot study using verbal protocols and video screen capture to characterize physician subjects' use of a traditional laboratory data display while reviewing unfamiliar inpatient cases. We found that subjects navigated to the laboratory display primarily to seek evidence confirming a result or problem identified elsewhere in the case. Additionally, 22% of the time subjects spontaneously reviewed anomalous findings and results related to other known problems. These results suggest that physicians have learned complex data acquisition behaviors for efficient interaction with source-oriented displays, and further study is needed to ensure that problem-oriented medical records do not lose the benefits of these behaviors.
authors.affiliation: Division of Clinical Informatics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Post
authors.forename: James
authors.initials: J
authors.lastname: Harrison
mesh_terms: D001519:Behavior; D019090:Case Management; D002984:Clinical Laboratory Information Systems; D003626:Data Display; D006801:Humans; D016247:Information Storage and Retrieval; D007297:Inpatients; D016347:Medical Records Systems, Computerized; D008501:Medical Records, Problem-Oriented; D010820:Physicians / Q000523:psychology; D010865:Pilot Projects; D012984:Software; D014584:User-Computer Interface