Faculty Collaboration Database

Oncologists' Views Regarding the Role of Electronic Health Records in Care Coordination. JCO Clin Cancer Inform 2018 Dec;2:1-12

Date

01/18/2019

Pubmed ID

30652555

DOI

10.1200/CCI.17.00118

Scopus ID

2-s2.0-85065908769 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

BACKGROUND: Electronic health records (EHRs) play a significant role in complex health care processes, especially in information transfer with patients and care coordination among providers. EHRs may also generate unintended consequences, introducing new patient safety risks. To date, little investigation has been performed in oncology settings, despite the need for quality provider-patient communication and information transfer during oncology visits. In this qualitative study, we focused on oncology providers' perceptions of EHRs for supporting communication with patients and coordination of care with other providers.

METHODS: We conducted semistructured interviews with oncologists from an urban academic medical center to learn their perceptions of the use of EHRs before, during, and after clinic visits with patients. Our interview guide was developed on the basis of the work system model. We coded transcripts using inductive content analysis.

RESULTS: Data analysis yielded four main themes regarding oncologists' practices in using the EHR and perceptions about EHRs: (1) EHR use for care coordination (eg, timeliness of receiving information, SmartSet documentation); (2) EHR use in the clinic visit (eg, educating patients, using as a reinforcement tool); (3) safety hazards in care coordination associated with EHRs (eg, incomplete documentation, error propagating, no filtering mechanism to capture errors); and (4) suggestions for improvements (eg, improved SmartSet functionalities, simplification of user interface).

CONCLUSION: Current EHRs do not adequately support teamwork of oncology providers, which could lead to potential hazards in the care of patients with cancer. Redesigning EHR features that are tailored to support oncology care and addressing the concerns regarding information overload, improved organization of flagging abnormal results, and documentation-related workload are needed to minimize potential safety hazards.

Author List

Asan O, Nattinger AB, Gurses AP, Tyszka JT, Yen TWF

Authors

Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Ambulatory Care Facilities
Attitude to Computers
Cooperative Behavior
Electronic Health Records
Female
Hospitals, Teaching
Hospitals, Urban
Humans
Interviews as Topic
Male
Middle Aged
Oncologists
Patient Care Team
Qualitative Research