title: Using High-Fidelity Simulation and Eye Tracking to Characterize EHR Workflow Patterns among Hospital Physicians.
abstract: Modern EHR systems are complex, and end-user behavior and training are highly variable. The need for clinicians to access key clinical data is a critical patient safety issue. This study used a mixed methods approach employing a high-fidelity EHR simulation environment, eye and screen tracking, surveys, and semi-structured interviews to characterize typical EHR usage by hospital physicians (hospitalists) as they encounter a new patient. The main findings were: 1) There were strong similarities across the groups in the information types the physicians looked at most frequently, 2) While there was no overall difference in case duration between the groups, we observed two distinct workflow types between the groups with respect to gathering information in the EHR and creating a note, and 3) A majority of the case time was devoted to note composition in both groups. This has implications for EHR interface design and raises further questions about what individual user workflows exist in the EHR.
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR.
authors.forename: Julie W
authors.initials: JW
authors.lastname: Doberne
authors.affiliation: University of Massachusetts Amherst, Amherst, MA.
authors.forename: Ze
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR.
authors.forename: Vishnu
authors.initials: V
authors.lastname: Mohan
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR; Department of Pulmonology & Critical Care, Oregon Health & Science University, Portland, OR.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gold
authors.affiliation: University of Massachusetts Amherst, Amherst, MA.
authors.forename: Jenna
authors.initials: J
authors.lastname: Marquard
authors.affiliation: Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR; Department of Ophthalmology, Oregon Health & Science University, Portland, OR.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Chiang
mesh_terms: D003198:Computer Simulation; D057286:Electronic Health Records; D020445:Hospitalists; D006801:Humans; D057188:Workflow