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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Weir, Charlene R Staggers, Nancy Gibson, Bryan Doing-Harris, Kristina Barrus, Robyn Dunlea, Robert |
| Abstract | Background Effective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients’ contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians’ perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas. Methods A qualitative design using Cognitive Task Analyses and a modified Critical Incident Technique were used. The study was conducted in a large VA with a fully implemented EHR located in the western United States. Seventeen providers working in a PCMH model of care in Primary Care, Home Based Care and Geriatrics reported on a recent difficult transition requiring contextual information for decision-making. The transcribed interviews were qualitatively analyzed for thematic development related to contextual information using an iterative process and multiple reviewers with ATLAS@ti software. Results Six overarching themes emerged as attributes of contextual information: Informativeness, goal language, temporality, source attribution, retrieval effort, and information quality. Conclusions These results indicate that specific attributes are needed to in order for contextual information to fully support clinical decision-making in a Medical Home care delivery environment. Improved EHR designs are needed for ease of contextual information access, displaying linkages across time and settings, and explicit linkages to both clinician and patient goals. Implications relevant to providers’ information needs, team functioning and EHR design are discussed. |
| Related Links | https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-015-0150-x.pdf |
| Ending Page | 8 |
| Page Count | 8 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14726947 |
| DOI | 10.1186/s12911-015-0150-x |
| Journal | BMC Medical Informatics and Decision Making |
| Issue Number | 1 |
| Volume Number | 15 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2015-04-16 |
| Access Restriction | Open |
| Subject Keyword | Health Informatics Information Systems and Communication Service Management of Computing and Information Systems Patient medical home Cognitive task analysis Contextual information Electronic health record Patient preferences Information access |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Informatics Computer Science Applications Health Policy |
| Journal Impact Factor | 3.3/2023 |
| 5-Year Journal Impact Factor | 3.9/2023 |
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