Information overload – A case study of using an integrated electronic health record system in the emergency room

Abstract

Background: In modern healthcare services, physically distributed and disciplinary specialized healthcare teams must cooperate under pressure and instantly share increasing amounts of patient information. Therefore, Electronic Health Record (EHR) systems are deployed to facilitate data sharing.
Purpose: We wanted to understand how Emergency Room (ER) teams use EHR systems in their daily practice. ER can be seen as an extreme case for EHR deployment because of extreme time pressure and the need for cross-disciplinary collaboration.
Methods: We used an interpretative case study approach, investigating an EHR system used in the ER department of a large hospital. We interviewed ER personnel, observed EHR use in real-world ambulatory settings, and consulted various documents to create a deeper understanding of the case.
Results: EHR systems are increasingly important in ER personnel’s practices. At the same time, the information in the EHR system can be perceived as irrelevant and duplicated, which leads to perceived information overload. Moreover, gaining an overview of relevant information under time pressure is difficult, which can lead to stress and frustration.
Conclusion: EHR systems play an increasingly important role in healthcare services and can sometimes be the only source of information about patients, such as in ER. ER teams must cooperate with multiple healthcare disciplines, often under extreme time and space conditions. Therefore, ER should be used as an important case for EHR design.