Clinical data needs in the neonatal intensive care unit electronic medical record

新生儿重症监护病房电子病历中的临床数据需求

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Abstract

BACKGROUND: The amount of clinical information that providers encounter daily creates an environment for information overload and medical error. To create a more efficient EMR human-computer interface, we aimed to understand clinical information needs among NICU providers. METHODS: A web-based survey to evaluate 98 data items was created and distributed to NICU providers. Participants were asked to rate the importance of each data item in helping them make routine clinical decisions in the NICU. RESULTS: There were 23 responses (92% - response rate) with participants distributed among four clinical roles. The top 5 items with the highest mean score were daily weight, pH, pCO2, FiO2, and blood culture results. When compared by clinical role groupings, supervisory physicians gave individual data item ratings at the extremes of the scale when compared to providers more responsible for the daily clinical care of NICU patients. CONCLUSION: NICU providers demonstrate a need for large amounts of EMR data to help guide clinical decision making with differences found when comparing by clinical role. When creating an EMR interface in the NICU there may be a need to offer options for varying degrees of viewable data densities depending on clinical role.

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