title: Integrating the Electronic Health Record into high-fidelity interprofessional intensive care unit simulations.
abstract: With the rapid adoption of electronic health records (EHR), there is a growing appreciation for the central role they play in clinical decision making and team communication, with many studies documenting new safety issues with integration of the EHR into the clinical enterprise. To study these issues, we created a high-fidelity simulation instance of our clinical EHR. In this paper, we describe the impact of integrating the EHR into high-fidelity, interprofessional intensive care unit (ICU) simulations, and the errors induced. We found a number of safety issues directly related to the EHR including alert fatigue, negative impacts on interprofessional communication, and problems with selective data gathering, and these issues were present for all members of the interprofessional team. Through successful integration of the EHR into high-fidelity team-based simulations, we now have an infrastructure to focus educational initiative and deploy informatics solutions to mitigate these safety issues.
authors.affiliation: a Division of Pulmonary and Critical Care Medicine and.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gold
authors.affiliation: a Division of Pulmonary and Critical Care Medicine and.
authors.forename: Alycia S R
authors.initials: AS
authors.lastname: Tutsch
authors.affiliation: a Division of Pulmonary and Critical Care Medicine and.
authors.forename: Adriel
authors.initials: A
authors.lastname: Gorsuch
authors.affiliation: b Department of Medical Informatics and Clinical Epidemiology , Oregon Health and Sciences University , Portland , OR , USA.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Mohan
mesh_terms: D003657:Decision Making; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D018805:Sepsis; D000066908:Simulation Training; D018511:Systems Integration
keywords: Critical care; informatics; interprofessional teamwork; patient safety; sepsis; shared decision making