Physician experiences of screen-level features in a prominent electronic health record: Design recommendations from a qualitative study

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  • Khairat, S.
    • Affiliation: University of North Carolina at Chapel Hill
  • Coleman, C.
    • Affiliation: University of North Carolina at Chapel Hill
  • Teal, R.
    • Affiliation: University of North Carolina at Chapel Hill
  • Rezk, S.
    • Affiliation: University of North Carolina at Chapel Hill
  • Rand, V.
    • Affiliation: University of North Carolina at Chapel Hill
  • Bice, T.
    • Affiliation: University of North Carolina at Chapel Hill
  • Carson, S.S.
    • Affiliation: University of North Carolina at Chapel Hill
Abstract
  • The goal of this qualitative study was to assess physicians’ perceptions around features of key screens within a prominent commercial EHR, and to solicit end-user recommendations for improved retrieval of high-priority clinical information. We conducted a qualitative, descriptive study of 25 physicians in a medical ICU setting. at a tertiary academic medical center. An in-depth, semi-structured interview guide was developed to elicit physician perceptions on information retrieval as well as favorable and unfavorable features of specific EHR screens. Transcripts were independently coded in a qualitative software management tool by at least two trained coders using a common code book. We successfully obtained vendor permission to map physicians perception’s on full Epic© screenshots. Among the 25 physician participants (13 female; 5 attending physicians, 9 fellows, 11 residents), the majority of participants reported experiencing challenges finding clinical information in the EHR. We present the most favorable and unfavorable screen-level features for four central EHR screens: Flowsheet, Notes/Chart Review, Results Review, and Vital Signs. We also compiled participants’ recommendations for a comprehensive EHR dashboard screen to better support clinical workflow and information retrieval in the medical ICU through User-Centered Design. ICU physicians demonstrated a mix of positive and negative attitudes toward specific screen-level features in a major vendor-based EHR system. Physician perceptions of information overload emerged as a theme across multiple EHR screens. Our findings underscore the importance of qualitative research and end-user feedback in EHR software design and interface optimization at both the vendor and institutional level.
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  • Article
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  • In Copyright
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  • Attribution 4.0 International
Journal title
  • Health Informatics Journal
Journal volume
  • 27
Journal issue
  • 1
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  • English
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  • Publisher
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  • 1460-4582
Publisher
  • SAGE Publications Inc.

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