title: Analysis of user behavior in accessing electronic medical record systems in emergency departments.
abstract: Electronic patient tracking and records systems in emergency departments often connect to hospital information systems, ambulatory patient records and ancillary systems. The networked systems may not be fully interoperable and clinicians need to access data through different interfaces. This study was conducted to describe the interactive behavior of clinicians working with partially interoperable clinical information systems. We performed 78 hours of observation at two emergency departments, shadowing five physicians, ten nurses and four administrative staff. Actions related to viewing or recording data in any system or on paper were recorded. Collected data were compared along clinical roles and contrasted with findings across the two hospital sites. The findings suggest that differences in the levels of interoperability may affect the ways physicians and nurses interact with the systems. When tradeoffs in functionality are necessary for connecting ancillary systems, the effects on clinicians and staff need to be considered.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jan
authors.initials: J
authors.lastname: Horsky
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Allen
authors.forename: Allison R
authors.initials: AR
authors.lastname: Wilcox
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Pollard
authors.forename: Pamela
authors.initials: P
authors.lastname: Neri
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pallin
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Rothschild
mesh_terms: D057286:Electronic Health Records; D004636:Emergency Service, Hospital; D006751:Hospital Information Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D009726:Nurses; D010820:Physicians