Appl Clin Inform - Determining primary care physician information needs to inform ambulatory visit note display.

Tópicos

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Resumo

CKGROUND: With the increase in the adoption of electronic health records (EHR) across the US, primary care physicians are experiencing information overload. The purpose of this pilot study was to determine the information needs of primary care physicians (PCPs) as they review clinic visit notes to inform EHR display.METHOD: Data collection was conducted with 15 primary care physicians during semi-structured interviews, including a third party observer to control bias. Physicians reviewed major sections of an artificial but typical acute and chronic care visit note to identify the note sections that were relevant to their information needs. Statistical methods used were McNemar-Mosteller's and Cochran Q.RESULTS: Physicians identified History of Present Illness (HPI), Assessment, and Plan (A&P) as the most important sections of a visit note. In contrast, they largely judged the Review of Systems (ROS) to be superfluous. There was also a statistical difference in physicians' highlighting among all seven major note sections in acute (p = 0.00) and chronic (p = 0.00) care visit notes.CONCLUSION: A&P and HPI sections were most frequently identified as important which suggests that physicians may have to identify a few key sections out of a long, unnecessarily verbose visit note. ROS is viewed by doctors as mostly "not needed," but can have relevant information. The ROS can contain information needed for patient care when other sections of the Visit note, such as the HPI, lack the relevant information. Future studies should include producing a display that provides only relevant information to increase physician efficiency at the point of care. Also, research on moving A&P to the top of visit notes instead of having A&P at the bottom of the page is needed, since those are usually the first sections physicians refer to and reviewing from top to bottom may cause cognitive load.

Resumo Limpo

ckground increas adopt electron health record ehr across us primari care physician experienc inform overload purpos pilot studi determin inform need primari care physician pcps review clinic visit note inform ehr displaymethod data collect conduct primari care physician semistructur interview includ third parti observ control bias physician review major section artifici typic acut chronic care visit note identifi note section relev inform need statist method use mcnemarmostel cochran qresult physician identifi histori present ill hpi assess plan ap import section visit note contrast larg judg review system ros superflu also statist differ physician highlight among seven major note section acut p chronic p care visit notesconclus ap hpi section frequent identifi import suggest physician may identifi key section long unnecessarili verbos visit note ros view doctor most need can relev inform ros can contain inform need patient care section visit note hpi lack relev inform futur studi includ produc display provid relev inform increas physician effici point care also research move ap top visit note instead ap bottom page need sinc usual first section physician refer review top bottom may caus cognit load

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