JMIR Publications

ABSTRACT

Background:

Physicians caring for patients with complex care needs often need to review large volumes of fragmented clinical information from several sources. Whether better access to more clinical notes is sufficient, or whether information must also be summarised and visualised to support clinical work, remains uncertain.

Objective:

The aim was to determine whether a digital tool integrating clinical notes from several sources with elements that summarise and visualise information (“DigiTeam”) improves the quality of physicians’ written case summaries and care plans for complex patient cases, and whether any improvement reflects summarising and visualising information, access to several sources, or both.

Methods:

A three-arm, parallel-group, superiority randomised controlled trial among physicians in Norway. Participants were randomised to one of three digital versions: access to clinical notes from a single-source, access to clinical notes from several sources, or DigiTeam, which combined notes from several sources with summaries and visualisations. Participants reviewed three real-world pseudonymised patient cases with complex care needs and wrote a patient summary and care plan for each case. The primary outcome was the quality of the written summaries and care plans, assessed against predefined expert-derived criteria.

Results:

Of 93 randomised physicians, 90 contributed data. Access to several sources did not improve overall quality compared with single-source access (mean difference 0.5, 95% CI −2.3 to 3.3; p=0.970). DigiTeam produced higher overall quality scores than multi-sources access without summarising and visualising elements (mean difference 6.49, 95% CI 3.2 to 9.8; p<0.001) and than single-source access (mean difference 6.95, 95% CI 3.7 to 10.2; p<0.001). DigiTeam also improved perceived information support, while time spent and usability did not differ between groups.

Conclusions:

A digital tool that summarised and visualised clinical information improved the quality of physicians’ summaries and care plans without increasing time use or reducing usability. In contrast, access to more clinical notes alone did not improve quality. These findings suggest that, for complex patient cases, how information is presented matters more than how much information is available. In short, summarised and visualised information improved quality; more information alone did not. Clinical Trial: ClinicalTrials.gov, NCT07142616, registered on 21 August 2025