Amrita Sinha
Stanford University Medical Center
Palo Alto, California
Disclosure information not submitted.
Daniel Tawfik, MD, MS
MD, MS
Stanford University School of Medicine, United States
Disclosure information not submitted.
Katherine Steffen, MD
MD
Stanford University School of Medicine, United States
Disclosure information not submitted.
Title: EHR Usability and Barriers to Efficient Information Gathering on the EHR in the PICU: Current State
Introduction: ICU providers are exposed to over 1200 patient data points per day and monitor around 190 alerts per patient per day. Poor electronic health record (EHR) usability and design may aggravate time spent gathering information on the EHR, which may limit face-to-face interactions with patients, delay care delivery, result in patient safety events and lead to EHR-related fatigue. We sought to measure EHR usability and identify barriers to efficient information gathering on the EHR among PICU providers.
Methods: Our study was conducted in a 36-bed PICU at Lucile Packard Children's Hospital Stanford in March 2021. The survey was disseminated to PICU attendings, fellows, nurse practitioners (NPs) and hospitalists.
Results: We had a survey response rate of 53% with 26 respondents including 14 attendings, 3 fellows, 7 NPs, and 2 hospitalists. Of the respondents, 76% had functioned in their current role and 96% had used Epic as their EHR system for 3 or more years. All respondents had clinical service obligations in the PICU in the past 3 months, median 6 weeks (IQR 3-9, range 1-12). The mean ± SD system usability score (SUS) was 48.8 ± 20.35, median 50 (IQR 42.5-62.5, range 10-82.5, maximum SUS possible 100). There was no significant association between SUS and provider type. Of the respondents, 43.4% were somewhat or extremely dissatisfied with the amount of time spent locating information in the EHR, and 27.2% reported that time spent locating information in the EHR affected their ability to go to bedside for over half of their EHR sessions. Frequent interruptions, difficulty remembering how to find EHR features, long EHR response times, scattered information on the EHR, and lack of awareness of useful features were rated as the top 5 barriers to efficient information gathering on the EHR.
Conclusions: EHR usability in the PICU is poor and is similar to that reported by other specialties. There is dissatisfaction around time spent on information gathering on the EHR in the PICU. Moreover, time spent gathering information on the EHR may also be affecting the ability to go to bedside. Our results may inform and guide EHR optimization, system and workflow improvement, and educational initiatives across PICUs which have the potential to improve patient care, provider efficiency and satisfaction.