Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 26, 2018
Open Peer Review Period: Sep 11, 2018 - Sep 5, 2018
Date Accepted: Dec 9, 2018
(closed for review but you can still tweet)
Clinicians’ Usage Paths of Mobile Electronic Health Records Vary Across Specialties
ABSTRACT
Background:
With the emergence of mobile devices, mobile electronic health record (m-EHR) systems have been utilized by clinicians and improved efficiency at the point of care. Although several studies on m-EHR, including analyses on its effects and health providers’ usage frequency, were conducted, only few considered the specific workflows of clinicians based on their specialties in which work process differs greatly.
Objective:
This study aims to investigate the differences in m-EHR usage paths across clinical specialties.
Methods:
We collected the log data of 974 clinicians, who worked from August 2016 to August 2017 and used the m-EHR system at Samsung Medical Center, one of the biggest hospitals in South Korea. The clinicians were classified into three groups based on their specialty: physicians, surgeons, and others. We used various descriptive and visualization methods to understand and compare clinicians’ usage paths of m-EHR. First, the average numbers of logins per day and contents used per login were examined over different specialties and positions. Second, the number of contents used by each clinician was visualized via a heat map to provide an overview of m-EHR usage across content types and clinicians’ specialties. Third, we conducted a path analysis via Sankey diagram, to describe main usage paths, and association rule mining, to find frequent paths in m-EHR usage.
Results:
The physician group logged on most frequently, whereas the other group did least frequently. Especially, the number of logins per day of residents in the physician group was 4.4 times higher than that of staff members in the other groups. Heat map visualization showed a visible difference among specialty groups. The physician group used more consult-related contents, whereas the surgeon group, more surgery-related contents. Generally, 50% of the clinicians spent about 15 seconds at a time when using m-EHR. In the Sankey diagram, the physician group showed diverse usage patterns with higher complexity compared with the other two groups. Especially, their paths contained more loops that could reflect repetitive checks on multiple patients. The most frequent path included inpatient summary, which means that most users stopped at the point of summary and did not proceed to view more details.
Conclusions:
The usage paths of m-EHR showed considerable differences among specialty groups. Such differences can be accommodated into an m-EHR design to enhance the efficiency of care. Clinical Trial: SMC 2017-12-074
Citation

Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.