Physicians do not devote the same amount of attention to all of the information in an electronic note, virtually ignoring medication lists, vital signs or lab results, according to a new study in Applied Clinical Informatics.
Researchers from Baystate Health in Springfield, Massachusetts, and elsewhere, conducted a study to determine how physicians distribute their visual attention when reading electronic notes, measuring the time spent on different parts of the note and the reading rates. They used an eye tracking device to assess the attention patterns of 10 hospitalists. They then compared the visual analysis with the content of simulated verbal hand-offs for each note and debriefing interviews.
The analysis found that physicians spent the most time in the "impression and plan" section of the notes--which they read very slowly--and very little time on medication lists, vital signs or lab results--which they read very quickly--even if those sections contained more content than the impression and plan section.
Only 9 percent of the content of the physicians' verbal hand-off was found outside the impression and plan section.
"Physicians in this study directed very little attention to medication lists, vital signs or laboratory results compared with the impression and plan section of electronic notes," the authors concluded. "Optimizing the design of electronic notes may include rethinking the amount and format of imported patient data as this data appears to largely be ignored."
EHR design has long been a concern to physicians, who find that they impeded workflow and the ability to interact with patients. Studies have found that this is one of the primary reasons why physicians tend to dislike using the systems.
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