Searching for the best way to extract EHR data

As more healthcare organizations move to EHRs, systems will start to fill up with terabytes upon terabytes of health data. Individual records will grow unbelievably long. And clinicians will need ways to search records.

A 2008 academic study from Norway (.pdf) found that general practitioners often relied on their own memory or asked patients to help them recall historical information in EHRs rather than searching for data in the record. More than a third of physicians in the study found it easier to ask patients than to search the record, and a similar proportion often gave up on searching because the process was too time-consuming. "It's information overload," Columbia University researcher Karthik Natarajan said in presenting a paper of his own this week at the American Medical Informatics Association's annual symposium in San Francisco.

"Search within EHR is not a new concept, but there hasn't been much literature on the subject," Natarajan said. His paper hoped to add to the discussion by exploring a search utility Columbia created for its own EHR. And he found that physicians, at least at Columbia, preferred to have search results returned in reverse chronological order rather than listed by relevance. In other words, they wanted to be able to view the most recent information, just like they would see when flipping through a paper chart.

So does this mean that doctors have to break their old habits because EHRs need to be more than computerized representations of paper records, or does it mean vendors need to do a better job organizing information? I'm no expert on systems design, but I'd love to hear from some of you who are. - Neil

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