EHR Design Flaws Limit Physicians' Situational Awareness, Risking Errors

Because of the complexity of a physician’s decision-making process, reduced situational awareness (SA) can lead to improper decisions and increase the risk of patients suffering adverse outcomes. They did a study to analyze the impact of electronic health records on primary care physicians’ SA.

Studies analyzed the interactions between electronic health records (EHRs) and primary care physicians (PCPs). The studies revealed significant issues with the use of EHRs and their associated communication challenges. The 19 studies that were synthesized revealed various shortcomings in using EHRs and presented various barriers to achieving SA. These were:

1. workflow misalignments,

2. usability issues, and

3. communication challenges.

For EHR data integrity, it characterized the lab results and care plans as incomplete, untimely, or irrelevant. Unmet information needs making it difficult for PCPs to get even Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload.

The conclusion — EHRs do not support the improvement of SA among primary care physicians. The study supports the importance of designing processes that are focused on improving SA for health information technology.

Reference

Savoy, A., Patel, H., Murphy, D., Meyer, A., Herout, J., & Singh, H. (2021). Electronic Health Records’ Support for Primary Care Physicians’ Situation Awareness: A Metanarrative Review. Human Factors: The Journal Of The Human Factors And Ergonomics Society, 001872082110143. doi: 10.1177/00187208211014300