Problems Identified With Gaps in EHR Functionality in Morning Rounds

Gaps in EHR design lead to workflow standardization issues, use of workarounds, team miscommunication

TUESDAY, March 5, 2019 (HealthDay News) -- There is a considerable amount of variability in the ways in which electronic health records (EHRs) are used during morning rounds, resulting in extensive use of workarounds and problems with team communication, according to a study published online Feb. 25 in PLOS ONE.

Shiri Assis-Hassid, Ph.D., from the Harvard John A. Paulson School of Engineering and Applied Sciences in Cambridge, Massachusetts, and colleagues applied a mixed-method approach, including observations of care teams during morning rounds, semistructured interviews, and an electronic survey of hospital inpatient clinicians, to examine the extent to which EHRs support care team workflow during hospital morning rounds. Emerging themes were identified from interview transcripts.

Based on data triangulation across the three analyses, the researchers identified four main findings. They found a high degree of variance in the ways care teams use EHRs during morning rounds. At critical points of care, there was pervasive use of workarounds. EHRs are not used for sharing information; furthermore, they often impede intra-care team communication. Finally, care team workflow is not adequately supported by system designs and hospital room settings.

"Although EHRs can improve health care quality and have done so in many ways, our findings show that there are many challenges in the current inpatient environment that need to be addressed if EHRs are to reach their full potential," the authors write.

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