Impact of document consolidation on healthcare providers' perceived workload and information reconciliation tasks: a mixed methods study.

TitleImpact of document consolidation on healthcare providers' perceived workload and information reconciliation tasks: a mixed methods study.
Publication TypeJournal Article
Year of Publication2019
AuthorsHosseini M, Faiola A, Jones J, Vreeman DJ, Wu H, Dixon BE
JournalJ Am Med Inform Assoc
Volume26
Issue2
Pagination134-142
Date Published2019 02 01
ISSN1527-974X
KeywordsData Aggregation, Electronic Health Records, Health Information Exchange, Health Personnel, Humans, Information Storage and Retrieval, Medical Records Systems, Computerized, Workload
Abstract

Background: Information reconciliation is a common yet complex and often time-consuming task performed by healthcare providers. While electronic health record systems can receive "outside information" about a patient in electronic documents, rarely does the computer automate reconciling information about a patient across all documents.

Materials and Methods: Using a mixed methods design, we evaluated an information system designed to reconcile information across multiple electronic documents containing health records for a patient received from a health information exchange (HIE) network. Nine healthcare providers participated in scenario-based sessions in which they manually consolidated information across multiple documents. Accuracy of consolidation was measured along with the time spent completing 3 different reconciliation scenarios with and without support from the information system. Participants also attended an interview about their experience. Perceived workload was evaluated quantitatively using the NASA-TLX tool. Qualitative analysis focused on providers' impression of the system and the challenges faced when reconciling information in practice.

Results: While 5 providers made mistakes when trying to manually reconcile information across multiple documents, no participants made a mistake when the system supported their work. Overall perceived workload decreased significantly for scenarios supported by the system (37.2% in referrals, 18.4% in medications, and 31.5% in problems scenarios, P < 0.001). Information reconciliation time was reduced significantly when the system supported provider tasks (58.8% in referrals, 38.1% in medications, and 65.1% in problem scenarios).

Conclusion: Automating retrieval and reconciliation of information across multiple electronic documents shows promise for reducing healthcare providers' task complexity and workload.

DOI10.1093/jamia/ocy158
Alternate JournalJ Am Med Inform Assoc
PubMed ID30566630
PubMed Central IDPMC6804409
Grant ListT15 LM012502 / LM / NLM NIH HHS / United States