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

• Published in: Health informatics journal Vol. 27; no. 1; p. 1460458221997914
• Main Authors: Khairat, Saif, Coleman, Cameron, Teal, Randall, Rezk, Salma, Rand, Victoria, Bice, Thomas, Carson, Shannon S
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2021; SAGE PUBLICATIONS, INC
• Subjects: Electronic health records; Information retrieval; Perceptions; Physicians; Qualitative research; ICU; electronic health records; user-centered design; information retrieval
• ISSN: 1460-4582; 1741-2811
• DOI: 10.1177/1460458221997914

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.