Dataset Information

What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

ABSTRACT:

Background

There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high.

Objective

The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such information is accessed.

Methods

Since 2010, an m-EMR has been used in a tertiary hospital in Seoul, South Korea. The usage logs of the m-EMR by doctors were gathered from March to December 2015. Descriptive analyses were conducted to explore the overall usage patterns of the m-EMR. To assess the value of the clinical information provided, the usage patterns of both the m-EMR and a hospital information system (HIS) were compared on an hourly basis. The peak usage times of the m-EMR were defined as continuous intervals having normalized usage values that are greater than 0.5. The usage logs were processed as an indicator representing specific clinical information using factor analysis. Random intercept logistic regression was used to explore the type of clinical information that is frequently accessed during the peak usage times.

Results

A total of 524,929 usage logs from 653 doctors (229 professors, 161 fellows, and 263 residents; mean age: 37.55 years; males: 415 [63.6%]) were analyzed. The highest average number of m-EMR usage logs (897) was by medical residents, whereas the lowest (292) was by surgical residents. The usage amount for three menus, namely inpatient list (47,096), lab results (38,508), and investigation list (25,336), accounted for 60.1% of the peak time usage. The HIS was used most frequently during regular hours (9:00 AM to 5:00 PM). The peak usage time of the m-EMR was early in the morning (6:00 AM to 10:00 AM), and the use of the m-EMR from early evening (5:00 PM) to midnight was higher than during regular business hours. Four factors representing the types of clinical information were extracted through factor analysis. Factors related to patient investigation status and patient conditions were associated with the peak usage times of the m-EMR (P<.01).

Conclusions

Access to information regarding patient investigation status and patient conditions is crucial for decision making during morning activities, including ward rounds. The m-EMRs allow doctors to maintain the continuity of their clinical information regardless of the time and location constraints. Thus, m-EMRs will best evolve in a manner that enhances the accessibility of clinical information helpful to the decision-making process under such constraints.

SUBMITTER: Kim J

PROVIDER: S-EPMC5666226 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

Kim Junetae J Lee Yura Y Lim Sanghee S Kim Jeong Hoon JH Lee Byungtae B Lee Jae-Ho JH

Journal of medical Internet research 20171018 10

<h4>Background</h4>There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high.<h4>Objective</h4>The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such i ...[more]

PMID: 29046269

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Project description:BackgroundWith the emergence of mobile devices, mobile electronic health record (mEHR) systems have been utilized by health care professionals (HCPs), including doctors, nurses, and other practitioners, to improve efficiency at the point of care. Although several studies on mEHR systems were conducted, including those analyzing their effects and HCPs' usage frequency, only a few considered the specific workflows of doctors based on their specialties in which the work process differs greatly.ObjectiveThis study aimed to investigate the differences in mEHR usage paths across clinical specialties.MethodsWe collected the log data of 974 doctors who worked from August 2016 to August 2017 and used the mEHR system at the Samsung Medical Center, one of the biggest hospitals in South Korea. The doctors were classified into 3 groups based on their specialty: the physician, the surgeon, and other hospital-based physician (OHBP) groups. We used various descriptive and visualization methods to understand and compare doctors' usage paths of mEHRs. First, the average numbers of log-ins per day and features used per log-in were examined over different specialties and positions. Second, the number of features used by each doctor was visualized via a heat map to provide an overview of mEHR usage across feature types and doctors' specialties. Third, we conducted a path analysis via a Sankey diagram to describe main usage paths and association rule mining to find frequent paths in mEHR usage.ResultsThe physician group logged on most frequently, whereas the OHBP group logged on least frequently. In fact, the number of log-ins per day of residents in the physician group was 4.4 times higher than that of staff members in the other groups. The heat map visualization showed a visible difference among specialty groups. The physician group used more consultation-related features, whereas the surgeon group used more surgery-related features. Generally, 50% of the doctors spent about 15 seconds at a time when using mEHRs. In the Sankey diagram, the physician group showed diverse usage patterns with higher complexity compared with the other 2 groups; in particular, their paths contained more loops, which reflected repetitive checks on multiple patients. The most frequent path included inpatient summary, which means that most users stopped at the point of summary and did not proceed to view more details.ConclusionsThe usage paths of mEHRs showed considerable differences among the specialty groups. Such differences can be accommodated into an mEHR design to enhance the efficiency of care.

Dataset Information

What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

Background

Objective

Methods

Results

Conclusions

Publications

What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

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