ArticleJMIR medical informatics2026
Electronic Health Record Workflows in Acute Care Surgery: Ethnographic Study.
Article in JMIR medical informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Systematic strategies to harness electronic health record (EHR) workflows, reduce redundancy, and support decision-making remain limited in acute care surgery (ACS). Understanding how EHR systems and workflows intersect with time-sensitive settings is critical to improving decision-making and outcomes in ACS. Objective: This study aimed to evaluate how ACS clinicians leverage the EHR for decision-making and to identify opportunities and challenges for EHR-enabled decision support. Methods: We conducted a qualitative ethnographic study over a 6-month period, combining in-depth interviews with 15 ACS surgeons and providers and 100 hours of "paired fieldwork" observations spanning the entire perioperative arc by a surgical provider and an organizational sociologist. Using constructivist grounded theory, we identified the enablers, challenges, and opportunities for EHR-enabled decision-making in ACS. Results: Surgeons fell into two groups: (1) those who accepted information overload as inherent to the EHR, relying on generic templates and standard attestations, and (2) others who viewed it as a problem to fix, actively correcting errors and composing individualized summaries. Ambiguity in billing requirements drove overdocumentation, resulting in "note bloat" that obscured high-yield information. EHR use during decision-making focused primarily on risk assessment, though navigation challenges hindered access to critical data. Forecasting key outcomes that alter management or facilitate shared decision-making was seen as valuable. Automated risk stratification, generated from live EHR data while minimizing alert fatigue, was seen as a potential solution. Conclusions: ACS clinicians use various tactics to navigate EHR challenges and focus on high-value tasks. Streamlined risk assessment using EHR data may strengthen decision-making in critical moments, but solutions must integrate seamlessly within existing workflows to provide rapid and accurate outputs that prioritize meaningful outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.