CIS: where are we going and what should we demand from industry?

Clinical data needs in the neonatal intensive care unit electronic medical record

Background

The amount of clinical information that providers encounter daily creates an environment for information overload and medical error. To create a more efficient EMR human-computer interface, we aimed to understand clinical information needs among NICU providers.

Methods

A web-based survey to evaluate 98 data items was created and distributed to NICU providers. Participants were asked to rate the importance of each data item in helping them make routine clinical decisions in the NICU.

Results

There were 23 responses (92% – response rate) with participants distributed among four clinical roles. The top 5 items with the highest mean score were daily weight, pH, pCO2, FiO2, and blood culture results. When compared by clinical role groupings, supervisory physicians gave individual data item ratings at the extremes of the scale when compared to providers more responsible for the daily clinical care of NICU patients.

Conclusion

NICU providers demonstrate a need for large amounts of EMR data to help guide clinical decision making with differences found when comparing by clinical role. When creating an EMR interface in the NICU there may be a need to offer options for varying degrees of viewable data densities depending on clinical role.

Information needs for the OR and PACU electronic medical record

OBJECTIVE

The amount of clinical information that anesthesia providers encounter creates an environment for information overload and medical error. In an effort to create more efficient OR and PACU EMR viewer platforms, we aimed to better understand the intraoperative and post-anesthesia clinical information needs among anesthesia providers.

MATERIALS AND METHODS

A web-based survey to evaluate 75 clinical data items was created and distributed to all anesthesia providers at our institution. Participants were asked to rate the importance of each data item in helping them make routine clinical decisions in the OR and PACU settings.

RESULTS

There were 107 survey responses with distribution throughout all clinical roles. 84% of the data items fell within the top 2 proportional quarters in the OR setting compared to only 65% in the PACU. Thirty of the 75 items (40%) received an absolutely necessary rating by more than half of the respondents for the OR setting as opposed to only 19 of the 75 items (25%) in the PACU. Only 1 item was rated by more than 20% of respondents as not needed in the OR compared to 20 data items (27%) in the PACU.

CONCLUSION

Anesthesia providers demonstrate a larger need for EMR data to help guide clinical decision making in the OR as compared to the PACU. When creating EMR platforms for these settings it is important to understand and include data items providers deem the most clinically useful. Minimizing the less relevant data items helps prevent information overload and reduces the risk for medical error.