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In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients\u2019 risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)\u2019 SA during clinical decision-making. <\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p> We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP\u2013EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs\u2019 clinical decision-making and care management for adults. Then, we mapped findings to an established SA framework to classify external factors (individual, task, and system) affecting PCPs\u2019 levels of SA (1\u2013Perception, 2\u2013Comprehension, and 3\u2013Projection) and identified SA barriers. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> From 1504 articles identified, we included and synthesized 19 studies. Study designs were largely noninterventional. Studies described EHR workflow misalignments, usability issues, and communication challenges. EHR information, including lab results and care plans, was characterized as incomplete, untimely, or irrelevant. Unmet information needs made it difficult for PCPs to obtain even basic SA, Level 1 SA. Prevalent barriers to PCPs developing SA with EHRs were errant mental models, attentional tunneling, and data overload. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Based on our review, EHRs do not support the development of higher levels of SA among PCPs. Review findings suggest SA-oriented design processes for health information technology could improve PCPs\u2019 SA, satisfaction, and decision-making. <\/jats:p><\/jats:sec>","DOI":"10.1177\/00187208211014300","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T18:56:08Z","timestamp":1621968968000},"page":"237-259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Electronic Health Records\u2019 Support for Primary Care Physicians\u2019 Situation Awareness: A Metanarrative Review"],"prefix":"10.1177","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9002-9234","authenticated-orcid":false,"given":"April","family":"Savoy","sequence":"first","affiliation":[{"name":"Indiana University-Purdue University Indianapolis, USA"},{"name":"Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA"},{"name":"Regenstrief Institute, Inc., Indianapolis, Indiana, USA"}]},{"given":"Himalaya","family":"Patel","sequence":"additional","affiliation":[{"name":"Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA"}]},{"given":"Daniel R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA"},{"name":"Baylor College of Medicine, Houston, Texas, USA"}]},{"given":"Ashley N. D.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA"},{"name":"Baylor College of Medicine, Houston, Texas, USA"}]},{"given":"Jennifer","family":"Herout","sequence":"additional","affiliation":[{"name":"Veterans Health Administration, Office of Health Informatics, Washington, DC, USA"}]},{"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA"},{"name":"Baylor College of Medicine, Houston, Texas, USA"}]}],"member":"179","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"bibr1-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocz065"},{"key":"bibr2-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114541513"},{"key":"bibr3-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1016\/j.apergo.2020.103077"},{"key":"bibr4-00187208211014300","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2011.06.100255"},{"key":"bibr5-00187208211014300","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2017.06.170028"},{"key":"bibr6-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-5056(99)00011-8"},{"key":"bibr7-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1112158"},{"key":"bibr8-00187208211014300","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677907"},{"key":"bibr9-00187208211014300","unstructured":"Carter J. H. (2015, September 21). A usability conundrum: Whether it is EHRs or hospital gowns, one size never fits all\u2026. EHR Science: Explorations in the Design and Implementation of Clinical Information Systems. https:\/\/www.ehrscience.com\/2015\/09\/21\/a-usability-conundrum-whether-it-is-ehrs-or-hospital-gowns-one-size-never-fits-all\/"},{"key":"bibr10-00187208211014300","unstructured":"Center for History and New Media at George Mason University. (2013). Zotero (Version 4). George Mason University. https:\/\/www.zotero.org\/"},{"key":"bibr11-00187208211014300","unstructured":"Clarivate Analytics. (2016\u20132019). EndNote (Version X7-X9). 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