Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study

BackgroundElectronic health records (EHRs) have been associated with information overload, causing providers to miss critical information, make errors, and delay care. Information overload can be especially prevalent in medical intensive care units (ICUs) where patients are o...

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Main Authors: Saif Khairat, Jennifer Morelli, Marcella H Boynton, Thomas Bice, Jeffrey A Gold, Shannon S Carson
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2025/1/e66127
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author Saif Khairat
Jennifer Morelli
Marcella H Boynton
Thomas Bice
Jeffrey A Gold
Shannon S Carson
author_facet Saif Khairat
Jennifer Morelli
Marcella H Boynton
Thomas Bice
Jeffrey A Gold
Shannon S Carson
author_sort Saif Khairat
collection DOAJ
description BackgroundElectronic health records (EHRs) have been associated with information overload, causing providers to miss critical information, make errors, and delay care. Information overload can be especially prevalent in medical intensive care units (ICUs) where patients are often critically ill and their charts contain large amounts of data points such as vitals, test and laboratory results, medications, and notes. ObjectiveWe propose to study the relationship between information overload and EHR use among medical ICU providers in 4 major United States medical centers. In this study, we examined 2 prominent EHR systems in the United States to generate reproducible and generalizable findings. MethodsOur study collected physiological and objective data through the use of a screen-mounted eye-tracker. We aim to characterize information overload in the EHR by examining ICU providers’ decision-making and EHR usability. We also surveyed providers on their institution’s EHR to better understand how they rate the system’s task load and usability using the NASA (National Aeronautics and Space Administration) Task Load Index and Computer System Usability Questionnaire. Primary outcomes include the number of eye fixations during each case, the number of correct decisions, the time to complete each case, and number of screens visited. Secondary outcomes include case complexity performance, frequency of mouse clicks, and EHR task load and usability using provided surveys. ResultsThis EHR usability study was funded in 2021. The study was initiated in 2022 with a completion date of 2025. Data collection for this study was completed in December 2023 and data analysis is ongoing with a total of 81 provider sessions recorded. ConclusionsOur study aims to characterize information overload in the EHR among medical ICU providers. By conducting a multisite, cross-sectional usability assessment of information overload in 2 leading EHRs, we hope to reveal mechanisms that explain information overload. The insights gained from this study may lead to potential improvements in EHR usability and interface design, which could improve health care delivery and patient safety. International Registered Report Identifier (IRRID)DERR1-10.2196/66127
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spelling doaj-art-ba76dd45fa294f908e9062560a81282f2025-02-11T15:47:38ZengJMIR PublicationsJMIR Research Protocols1929-07482025-02-0114e6612710.2196/66127Investigation of Information Overload in Electronic Health Records: Protocol for Usability StudySaif Khairathttps://orcid.org/0000-0002-8992-2946Jennifer Morellihttps://orcid.org/0009-0005-2399-7880Marcella H Boyntonhttps://orcid.org/0000-0001-7793-2111Thomas Bicehttps://orcid.org/0000-0001-7300-3219Jeffrey A Goldhttps://orcid.org/0000-0001-6683-9907Shannon S Carsonhttps://orcid.org/0000-0001-6220-7005 BackgroundElectronic health records (EHRs) have been associated with information overload, causing providers to miss critical information, make errors, and delay care. Information overload can be especially prevalent in medical intensive care units (ICUs) where patients are often critically ill and their charts contain large amounts of data points such as vitals, test and laboratory results, medications, and notes. ObjectiveWe propose to study the relationship between information overload and EHR use among medical ICU providers in 4 major United States medical centers. In this study, we examined 2 prominent EHR systems in the United States to generate reproducible and generalizable findings. MethodsOur study collected physiological and objective data through the use of a screen-mounted eye-tracker. We aim to characterize information overload in the EHR by examining ICU providers’ decision-making and EHR usability. We also surveyed providers on their institution’s EHR to better understand how they rate the system’s task load and usability using the NASA (National Aeronautics and Space Administration) Task Load Index and Computer System Usability Questionnaire. Primary outcomes include the number of eye fixations during each case, the number of correct decisions, the time to complete each case, and number of screens visited. Secondary outcomes include case complexity performance, frequency of mouse clicks, and EHR task load and usability using provided surveys. ResultsThis EHR usability study was funded in 2021. The study was initiated in 2022 with a completion date of 2025. Data collection for this study was completed in December 2023 and data analysis is ongoing with a total of 81 provider sessions recorded. ConclusionsOur study aims to characterize information overload in the EHR among medical ICU providers. By conducting a multisite, cross-sectional usability assessment of information overload in 2 leading EHRs, we hope to reveal mechanisms that explain information overload. The insights gained from this study may lead to potential improvements in EHR usability and interface design, which could improve health care delivery and patient safety. International Registered Report Identifier (IRRID)DERR1-10.2196/66127https://www.researchprotocols.org/2025/1/e66127
spellingShingle Saif Khairat
Jennifer Morelli
Marcella H Boynton
Thomas Bice
Jeffrey A Gold
Shannon S Carson
Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
JMIR Research Protocols
title Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
title_full Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
title_fullStr Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
title_full_unstemmed Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
title_short Investigation of Information Overload in Electronic Health Records: Protocol for Usability Study
title_sort investigation of information overload in electronic health records protocol for usability study
url https://www.researchprotocols.org/2025/1/e66127
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