{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T01:35:12Z","timestamp":1775957712433,"version":"3.50.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"University of Wisconsin Institute for Clinical Translational Research Novel Methods Pilot Award"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR002373"],"award-info":[{"award-number":["UL1TR002373"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The electronic health record (EHR) data deluge makes data retrieval more difficult, escalating cognitive load and exacerbating clinician burnout. New auto-summarization techniques are needed. The study goal was to determine if problem-oriented view (POV) auto-summaries improve data retrieval workflows. We hypothesized that POV users would perform tasks faster, make fewer errors, be more satisfied with EHR use, and experience less cognitive load as compared with users of the standard view (SV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Simple data retrieval tasks were performed in an EHR simulation environment. A randomized block design was used. In the control group (SV), subjects retrieved lab results and medications by navigating to corresponding sections of the electronic record. In the intervention group (POV), subjects clicked on the name of the problem and immediately saw lab results and medications relevant to that problem.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>With POV, mean completion time was faster (173 seconds for POV vs 205 seconds for SV; P\u2009&amp;lt;\u2009.0001), the error rate was lower (3.4% for POV vs 7.7% for SV; P\u2009=\u2009.0010), user satisfaction was greater (System Usability Scale score 58.5 for POV vs 41.3 for SV; P\u2009&amp;lt;\u2009.0001), and cognitive task load was less (NASA Task Load Index score 0.72 for POV vs 0.99 for SV; P\u2009&amp;lt;\u2009.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The study demonstrates that using a problem-based auto-summary has a positive impact on 4 aspects of EHR data retrieval, including cognitive load.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>EHRs have brought on a data deluge, with increased cognitive load and physician burnout. To mitigate these increases, further development and implementation of auto-summarization functionality and the requisite knowledge base are needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocaa332","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T22:16:27Z","timestamp":1609971387000},"page":"899-906","source":"Crossref","is-referenced-by-count":23,"title":["Impact of a problem-oriented view on clinical data retrieval"],"prefix":"10.1093","volume":"28","author":[{"given":"Michael G","family":"Semanik","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA"}]},{"given":"Peter C","family":"Kleinschmidt","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA"}]},{"given":"Adam","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3087-4193","authenticated-orcid":false,"given":"Duwayne L","family":"Willett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}]},{"given":"Shannon M","family":"Dean","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5959-1659","authenticated-orcid":false,"given":"Sameh N","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}]},{"given":"Zoe","family":"Co","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}]},{"given":"Emmanuel","family":"Sampene","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA"}]},{"given":"Joel R","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA"}]}],"member":"286","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"issue":"2","key":"2021042419044671600_ocaa332-B1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1093\/jamia\/ocy145","article-title":"Physician stress and burnout: the impact of health information technology","volume":"26","author":"Gardner","year":"2019","journal-title":"J Am Med Inform Assoc"},{"issue":"23","key":"2021042419044671600_ocaa332-B2","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1001\/jama.2012.4946","article-title":"A piece of my mind. The cost of technology","volume":"307","author":"Toll","year":"2012","journal-title":"Jama"},{"key":"2021042419044671600_ocaa332-B3","author":"Friedberg","year":"2013"},{"issue":"7","key":"2021042419044671600_ocaa332-B4","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.mayocp.2016.05.007","article-title":"Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction","volume":"91","author":"Shanafelt","year":"2016","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2021042419044671600_ocaa332-B5","doi-asserted-by":"crossref","first-page":"50","DOI":"10.7326\/M18-0139","article-title":"Physician burnout in the electronic health record era: are we ignoring the real cause?","volume":"169","author":"Downing","year":"2018","journal-title":"Ann Intern Med"},{"key":"2021042419044671600_ocaa332-B6"},{"issue":"11","key":"2021042419044671600_ocaa332-B7","doi-asserted-by":"crossref","first-page":"784","DOI":"10.7326\/M18-1422","article-title":"Estimating the attributable cost of physician burnout in the United States","volume":"170","author":"Han","year":"2019","journal-title":"Ann Intern Med"},{"issue":"1","key":"2021042419044671600_ocaa332-B8","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1186\/s12913-018-3663-z","article-title":"Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study","volume":"18","author":"Hamidi","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"2021042419044671600_ocaa332-B9","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1016\/j.jbi.2011.03.008","article-title":"Summarization of clinical information: a conceptual model","volume":"44","author":"Feblowitz","year":"2011","journal-title":"J Biomed Inform"},{"issue":"1","key":"2021042419044671600_ocaa332-B10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4338\/ACI-2011-11-RA-0066","article-title":"Clinical summarization capabilities of commercially-available and internally-developed electronic health records","volume":"3","author":"Laxmisan","year":"2012","journal-title":"Appl Clin Inform"},{"issue":"11","key":"2021042419044671600_ocaa332-B11","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1001\/jamainternmed.2014.4506","article-title":"Use of internist\u2019s free time by ambulatory care electronic medical record systems","volume":"174","author":"McDonald","year":"2014","journal-title":"JAMA Intern Med"},{"issue":"5","key":"2021042419044671600_ocaa332-B12","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1093\/jamia\/ocv032","article-title":"Automated methods for the summarization of electronic health records","volume":"22","author":"Pivovarov","year":"2015","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2021042419044671600_ocaa332-B13","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1472-6947-8-12","article-title":"Instant availability of patient records, but diminished availability of patient information: a multi-method study of GP\u2019s use of electronic patient records","volume":"8","author":"Christensen","year":"2008","journal-title":"BMC Med Inform Decis Mak"},{"issue":"1","key":"2021042419044671600_ocaa332-B14","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s12911-018-0703-x","article-title":"Primary care physicians\u2019 attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework","volume":"18","author":"O\u2019Donnell","year":"2018","journal-title":"BMC Med Inform Decis Mak"},{"issue":"12","key":"2021042419044671600_ocaa332-B15","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1056\/NEJM196803212781204","article-title":"Medical records that guide and teach","volume":"278","author":"Weed","year":"1968","journal-title":"N Engl J Med"},{"key":"2021042419044671600_ocaa332-B16","first-page":"239","author":"Schultz","year":"1971"},{"key":"2021042419044671600_ocaa332-B17","first-page":"463","article-title":"Taking the problem oriented medical record forward","author":"Salmon","year":"1996","journal-title":"Proc AMIA Annu Fall Symp"},{"key":"2021042419044671600_ocaa332-B18","year":"2009"},{"issue":"6","key":"2021042419044671600_ocaa332-B19","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJMp1006114","article-title":"The \u201cMeaningful Use\u201d regulation for electronic health records","volume":"363","author":"Blumenthal","year":"2010","journal-title":"N Engl J Med"},{"key":"2021042419044671600_ocaa332-B20","first-page":"53967","article-title":"Medicare and Medicaid programs; electronic health record incentive program\u2013stage 2. Final rule","volume":"77","year":"2012","journal-title":"Fed Regist"},{"key":"2021042419044671600_ocaa332-B21","article-title":"The Problem Oriented Medical Record - just a little more structure to help the world go round?","author":"Bainbridge","year":"1996","journal-title":"Proceedings of the 1996 Annual Conference of the Primary Health Care Specialist Group;"},{"key":"2021042419044671600_ocaa332-B22","doi-asserted-by":"crossref","DOI":"10.1186\/s12911-016-0341-0","article-title":"Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature","volume":"16","author":"Simons","year":"2016","journal-title":"BMC Med Inform Decis Mak"},{"issue":"2","key":"2021042419044671600_ocaa332-B23","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1148\/rg.292085098","article-title":"Problem-centric organization and visualization of patient imaging and clinical data","volume":"29","author":"Bashyam","year":"2009","journal-title":"Radiographics"},{"issue":"6","key":"2021042419044671600_ocaa332-B24","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.jbi.2010.09.009","article-title":"An automated technique for identifying associations between medications, laboratory results and problems","volume":"43","author":"Wright","year":"2010","journal-title":"J Biomed Inform"},{"issue":"4","key":"2021042419044671600_ocaa332-B25","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1136\/amiajnl-2011-000521","article-title":"Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial","volume":"19","author":"Wright","year":"2012","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2021042419044671600_ocaa332-B26","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1136\/amiajnl-2011-000121","article-title":"A method and knowledge base for automated inference of patient problems from structured data in an electronic medical record","volume":"18","author":"Wright","year":"2011","journal-title":"J Am Med Inform Assoc"},{"key":"2021042419044671600_ocaa332-B27","author":"Kane"},{"key":"2021042419044671600_ocaa332-B28","author":"Jha","year":"2019"},{"issue":"1","key":"2021042419044671600_ocaa332-B29","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/jamiaopen\/ooy016","article-title":"The electronic elephant in the room: Physicians and the electronic health record","volume":"1","author":"Kroth","year":"2018","journal-title":"JAMIA Open"},{"issue":"8","key":"2021042419044671600_ocaa332-B30","doi-asserted-by":"crossref","first-page":"e199609","DOI":"10.1001\/jamanetworkopen.2019.9609","article-title":"Association of electronic health record design and use factors with clinician stress and burnout","volume":"2","author":"Kroth","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"7064","key":"2021042419044671600_ocaa332-B31","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1136\/bmj.313.7064.1062","article-title":"What clinical information do doctors need?","volume":"313","author":"Smith","year":"1996","journal-title":"Bmj"},{"issue":"11","key":"2021042419044671600_ocaa332-B32","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1016\/j.ajem.2013.06.028","article-title":"4000 Clicks: a productivity analysis of electronic medical records in a community hospital ED","volume":"31","author":"Hill","year":"2013","journal-title":"Am J Emerg Med"},{"key":"2021042419044671600_ocaa332-B33","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41746-018-0029-1","article-title":"Scalable and accurate deep learning with electronic health records","volume":"1","author":"Rajkomar","year":"2018","journal-title":"Npj Digit Med"},{"issue":"01","key":"2021042419044671600_ocaa332-B34","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4338\/ACI-2016-04-IE-0054","article-title":"Accelerating the benefits of the problem oriented medical record","volume":"26","author":"Buchanan","year":"2017","journal-title":"Appl Clin Inform"},{"key":"2021042419044671600_ocaa332-B35"},{"key":"2021042419044671600_ocaa332-B36"},{"key":"2021042419044671600_ocaa332-B37"},{"key":"2021042419044671600_ocaa332-B38"},{"key":"2021042419044671600_ocaa332-B39","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1097\/CCM.0b013e31821858a0","article-title":"The effect of two different electronic health record user interfaces on intensive care provider task load, errors of cognition, and performance","volume":"39","author":"Ahmed","year":"2011","journal-title":"Crit Care Med"},{"issue":"5","key":"2021042419044671600_ocaa332-B40","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.ijmedinf.2015.01.017","article-title":"The implementation of clinician designed, human-centered electronic medical record viewer in the intensive care unit: a pilot step-wedge cluster randomized trial","volume":"84","author":"Pickering","year":"2015","journal-title":"Int J Med Inform"},{"issue":"4","key":"2021042419044671600_ocaa332-B41","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1055\/s-0039-1694748","article-title":"Using cognitive load theory to improve posthospitalization follow-up visits","volume":"10","author":"Harry","year":"2019","journal-title":"Appl Clin Inform"},{"issue":"1","key":"2021042419044671600_ocaa332-B42","doi-asserted-by":"crossref","first-page":"e1919301","DOI":"10.1001\/jamanetworkopen.2019.19301","article-title":"Association of health record visualizations with physicians\u2019 cognitive load when prioritizing hospitalized patients","volume":"3","author":"Pollack","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2021042419044671600_ocaa332-B43","first-page":"4","article-title":"SUS-A quick and dirty usability scale","volume":"189","author":"Brooke","year":"1996","journal-title":"Usability Eval Ind"},{"key":"2021042419044671600_ocaa332-B44","first-page":"139","volume-title":"Advances in Psychology","author":"Hart","year":"1988"},{"issue":"3","key":"2021042419044671600_ocaa332-B45","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.mayocp.2019.09.024","article-title":"The association between perceived electronic health record usability and professional burnout among US Physicians","volume":"95","author":"Melnick","year":"2020","journal-title":"Mayo Clin Proc"},{"issue":"4","key":"2021042419044671600_ocaa332-B46","doi-asserted-by":"crossref","first-page":"e191709","DOI":"10.1001\/jamanetworkopen.2019.1709","article-title":"Association of the usability of electronic health records with cognitive workload and performance levels among physicians","volume":"2","author":"Mazur","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2021042419044671600_ocaa332-B47","year":"2020"},{"key":"2021042419044671600_ocaa332-B48","doi-asserted-by":"crossref","first-page":"103175","DOI":"10.1016\/j.jbi.2019.103175","article-title":"A mixed-methods evaluation framework for electronic health records usability studies","volume":"94","author":"Khairat","year":"2019","journal-title":"J Biomed Inform"},{"key":"2021042419044671600_ocaa332-B49","first-page":"4","article-title":"Cognitive load and its implications for health care","author":"Harry","year":"2018","journal-title":"NEJM Catalyst"},{"key":"2021042419044671600_ocaa332-B50","first-page":"26","article-title":"Some unintended consequences of clinical decision support systems","volume":"2007","author":"Ash","year":"2007","journal-title":"AMIA Annu Symp Proc"},{"key":"2021042419044671600_ocaa332-B51","first-page":"656","article-title":"Preliminary evaluation of the Chest Pain Dashboard, a FHIR-based approach for integrating health information exchange information directly into the clinical workflow","volume":"2019","author":"Schleyer","year":"2019","journal-title":"AMIA Jt Summits Transl Sci Proc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/899\/37334934\/ocaa332.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/5\/899\/37334934\/ocaa332.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T19:08:26Z","timestamp":1619291306000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/28\/5\/899\/6131665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,10]]},"references-count":51,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,2,10]]},"published-print":{"date-parts":[[2021,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocaa332","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,5,1]]},"published":{"date-parts":[[2021,2,10]]}}}