title: Foraging for Information in the EHR: The Search for Adherence Related Information by Mental Health Clinicians.
abstract: In this project we sought to qualitatively describe clinician's search for information related to the complex construct of adherence. Nineteen think aloud observations and semi-structured interviews were conducted with mental health providers as they prepared for a patient visit. The transcripts were coded according to constructs from information foraging theory (information goal, patch, scent, enrichment, and opportunity cost). The search strategies uncovered were complicated: provider's searches were sometimes multi-staged (e.g. a search of the EHR led to further enquiry when interviewing the patient), and involved multiple 'patches' (i.e. data from the EHR, the patient and other providers were all sought out). In addition, some information that providers considered relevant to understand adherence related questions was non-obvious (e.g. the absence of specific information was considered a useful cue). Providers' information search strategies for complex constructs are at times non-intuitive; implications for the design of EHR summarization tools are discussed.
authors.affiliation: IDEAS 20 Center George E Whalen VA Medical Center, Salt Lake City, UT; Department of Biomedical informatics, University of Utah, Salt lake City, UT.
authors.forename: Bryan
authors.initials: B
authors.lastname: Gibson
authors.affiliation: IDEAS 20 Center George E Whalen VA Medical Center, Salt Lake City, UT; Geriatric Research Education and Clinical Center George E. Whalen VA Medical Center, Salt Lake City, UT; Division of Geriatrics, University of Utah, Salt Lake City, UT.
authors.forename: Jorie
authors.initials: J
authors.lastname: Butler
authors.affiliation: Portland VA Medical Center, Portland, OR.
authors.forename: Maryan
authors.initials: M
authors.lastname: Zirkle
authors.affiliation: Puget Sound Health Care System, Seattle WA; University of Washington, Seattle WA.
authors.forename: Kenric
authors.initials: K
authors.lastname: Hammond
authors.affiliation: IDEAS 20 Center George E Whalen VA Medical Center, Salt Lake City, UT; Department of Biomedical informatics, University of Utah, Salt lake City, UT.
authors.forename: Charlene
authors.initials: C
authors.lastname: Weir
mesh_terms: D057286:Electronic Health Records; D006801:Humans; D057226:Information Seeking Behavior; D016247:Information Storage and Retrieval; D007407:Interviews as Topic; D008605:Mental Health Services; D011584:Psychology; D000068217:Social Workers; D013997:Time Factors; D014584:User-Computer Interface