Clinicians� Usage Paths of Mobile Electronic Medical Records Vary Across Specialties (Preprint)

Abstract

BACKGROUND With the emergence of mobile devices, mobile electronic medical record (m-EMR) systems have been utilized by clinicians and improved efficiency at the point of care. Although several studies on m-EMR, 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-EMR 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-EMR 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-EMR. First, the average numbers of log-on per day and contents used per log-on 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-EMR 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-EMR usage. RESULTS The physician group logged on most frequently, whereas the other group did least frequently. Especially, the number of log-ons 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-EMR. In the Sankey diagram, we observed that the physician group demonstrated more loops, reflecting repetitive checks on multiple patients. Their paths were also diverse with higher complexity compared with the other two groups. 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-EMR showed considerable differences among specialty groups. Such differences can be accommodated into an m-EMR design to enhance the efficiency of care. CLINICALTRIAL Clinical Trials: SMC 2017-12-074