title: Point-of-care clinical documentation: assessment of a bladder cancer informatics tool (eCancerCareBladder): a randomized controlled study of efficacy, efficiency and user friendliness compared with standard electronic medical records.
abstract: OBJECTIVE
  To compare the use of structured reporting software and the standard electronic medical records (EMR) in the management of patients with bladder cancer. The use of a human factors laboratory to study management of disease using simulated clinical scenarios was also assessed.
  
  
  METHODS
  eCancerCare(Bladder) and the EMR were used to retrieve data and produce clinical reports. Twelve participants (four attending staff, four fellows, and four residents) used either eCancerCare(Bladder) or the EMR in two clinical scenarios simulating cystoscopy surveillance visits for bladder cancer follow-up.
  
  
  METHODS
  Time to retrieve and quality of review of the patient history; time to produce and completeness of a cystoscopy report. Finally, participants provided a global assessment of their computer literacy, familiarity with the two systems, and system preference.
  
  
  RESULTS
  eCancerCare(Bladder) was faster for data retrieval (scenario 1: 146 s vs 245 s, p=0.019; scenario 2: 306 vs 415 s, NS), but non-significantly slower to generate a clinical report. The quality of the report was better in the eCancerCare(Bladder) system (scenario 1: p<0.001; scenario 2: p=0.11). User satisfaction was higher with the eCancerCare(Bladder) system, and 11/12 participants preferred to use this system.
  
  
  CONCLUSIONS
  The small sample size affected the power of our study to detect differences.
  
  
  CONCLUSIONS
  Use of a specific data management tool does not appear to significantly reduce user time, but the results suggest improvement in the level of care and documentation and preference by users. Also, the use of simulated scenarios in a laboratory setting appears to be a valid method for comparing the usability of clinical software.
authors.affiliation: Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bostrom
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Toren
authors.forename: Hao
authors.initials: H
authors.lastname: Xi
authors.forename: Raymond
authors.initials: R
authors.lastname: Chow
authors.forename: Tran
authors.initials: T
authors.lastname: Truong
authors.forename: Justin
authors.initials: J
authors.lastname: Liu
authors.forename: Kelly
authors.initials: K
authors.lastname: Lane
authors.forename: Laura
authors.initials: L
authors.lastname: Legere
authors.forename: Anjum
authors.initials: A
authors.lastname: Chagpar
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Zlotta
authors.forename: Antonio
authors.initials: A
authors.lastname: Finelli
authors.forename: Neil E
authors.initials: NE
authors.lastname: Fleshner
authors.forename: Ethan D
authors.initials: ED
authors.lastname: Grober
authors.forename: Michael A S
authors.initials: MA
authors.lastname: Jewett
mesh_terms: D001292:Attitude to Computers; D003258:Consumer Behavior; D004282:Documentation; D057286:Electronic Health Records; D006801:Humans; D019451:Information Management / Q000379:methods*; D016247:Information Storage and Retrieval; D019095:Point-of-Care Systems; D012984:Software; D011795:Surveys and Questionnaires; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000628:therapy*; D014584:User-Computer Interface