title: Visualizing collaborative electronic health record usage for hospitalized patients with heart failure.
abstract: OBJECTIVE
  To visualize and describe collaborative electronic health record (EHR) usage for hospitalized patients with heart failure.
  
  
  METHODS
  We identified records of patients with heart failure and all associated healthcare provider record usage through queries of the Northwestern Medicine Enterprise Data Warehouse. We constructed a network by equating access and updates of a patient's EHR to a provider-patient interaction. We then considered shared patient record access as the basis for a second network that we termed the provider collaboration network. We calculated network statistics, the modularity of provider interactions, and provider cliques.
  
  
  RESULTS
  We identified 548 patient records accessed by 5113 healthcare providers in 2012. The provider collaboration network had 1504 nodes and 83 998 edges. We identified 7 major provider collaboration modules. Average clique size was 87.9 providers. We used a graph database to demonstrate an ad hoc query of our provider-patient network.
  
  
  CONCLUSIONS
  Our analysis suggests a large number of healthcare providers across a wide variety of professions access records of patients with heart failure during their hospital stay. This shared record access tends to take place not only in a pairwise manner but also among large groups of providers.
  
  
  CONCLUSIONS
  EHRs encode valuable interactions, implicitly or explicitly, between patients and providers. Network analysis provided strong evidence of multidisciplinary record access of patients with heart failure across teams of 100+ providers. Further investigation may lead to clearer understanding of how record access information can be used to strategically guide care coordination for patients hospitalized for heart failure.
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA nicholas.soulakis@northwestern.edu.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Soulakis
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA Center For Healthcare Studies, Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Carson
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Young Ji
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Northwestern University Clinical and Translational Sciences Institute, Chicago, IL, USA.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Schneider
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Connor T
authors.initials: CT
authors.lastname: Skeehan
authors.affiliation: Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Scholtens
mesh_terms: D003626:Data Display; D057225:Data Mining; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006282:Health Personnel; D006333:Heart Failure; D006760:Hospitalization; D006801:Humans; D010363:Pattern Recognition, Automated; D014584:User-Computer Interface
keywords: Care collaboration; electronic health records; heart failure; network analysis