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THE INNOVATION We developed an innovative approach to peer-to-peer sharing of best practices using the Electronic Medical Record (EMR). Why? The challenges of EMR training are twofold: (1) even the [...]

Objective: Most electronic health records display historical medication information only in a data table or clinician notes. We designed a medication timeline visualization intended to improve ease of use, speed, and accuracy in the ambulatory care of chronic disease.Materials and Methods: We identified information needs for understanding a patient medication history, then applied human factors and interaction design principles to support that process. After research and analysis of existing medication lists and timelines to guide initial requirements, we hosted design workshops with multidisciplinary stakeholders to expand on our initial concepts. Subsequent core team meetings used an iterative user-centered design approach to refine our prototype. Finally, a small pilot evaluation of the design was conducted with practicing physicians.Results: We propose an open-source online prototype that incorporates user feedback from initial design workshops, and broad multidisciplinary audience feedback. We describe the applicable design principles associated with each of the prototype's key features. A pilot evaluation of the design showed improved physician performance in 5 common medication-related tasks, compared to tabular presentation of the same information.Discussion: There is industry interest in developing medication timelines based on the example prototype concepts. An open, standards-based technology platform could enable developers to create a medication timeline that could be deployable across any compatible health IT application.Conclusion: The design goal was to improve physician understanding of a patient's complex medication history, using a medication timeline visualization. Such a design could reduce temporal and cognitive load on physicians for improved and safer care. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the information needs of primary care patients as they review clinic visit notes to inform information that should be contained in an after-visit summary (AVS).Method: We collected data from 15 patients with an acute illness and 14 patients with a chronic disease using semi-structured interviews. The acute patients reviewed seven major sections, and chronic patients reviewed eight major sections of a simulated, but realistic visit note to identify relevant information needs for their AVS.Results: Patients in the acute illness group identified the Plan, Assessment and History of Present Illness the most as important note sections, while patients in the chronic care group identified Significant Lab Data, Plan, and Assessment the most as important note sections.Discussion: This study was able to identify primary care patients' information needs after clinic visit. Primary care patients have information needs pertaining to diagnosis and treatment, which may be the reason why both patient groups identified Plan and Assessment as important note sections. Future research should also develop and assess an AVS based on the information gathered in this study and evaluate its usefulness among primary care patients.Practice Implications: The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence. [ABSTRACT FROM AUTHOR]

The article presents a study which compares the accuracy of diabetes dashboard screen and conventional approach in accessing multiple electronic health record (EHR) for high-quality diabetes care. The time, accuracy, and number of mouse clicks were measured while 10 primary care physicians searched their EHR using dashboard and conventional approach. Results show that dashboard screen is the most accurate because 100% of the data requested was identified correctly with 3 clicks in the mouse.

The article discusses some of the challenges associated with making electronic health record (EHR) notes more readable as well as some of the ways in which they can be made easier to read, assimilate and use. The main challenge is that EHR notes try to meet the needs try to meet the needs of too many stakeholders and all foreseeable tasks. The need should be to provide readers with what they need, when they need it, and nothing more. The EHR should be seen to have 6 layers to be effective.

The article offers a way to use smartphone (iPhone or Android) technology to avoid expense and delay while documentation in the electronic health record (EHR).