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      What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

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          Abstract

          Background

          There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high.

          Objective

          The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such information is accessed.

          Methods

          Since 2010, an m-EMR has been used in a tertiary hospital in Seoul, South Korea. The usage logs of the m-EMR by doctors were gathered from March to December 2015. Descriptive analyses were conducted to explore the overall usage patterns of the m-EMR. To assess the value of the clinical information provided, the usage patterns of both the m-EMR and a hospital information system (HIS) were compared on an hourly basis. The peak usage times of the m-EMR were defined as continuous intervals having normalized usage values that are greater than 0.5. The usage logs were processed as an indicator representing specific clinical information using factor analysis. Random intercept logistic regression was used to explore the type of clinical information that is frequently accessed during the peak usage times.

          Results

          A total of 524,929 usage logs from 653 doctors (229 professors, 161 fellows, and 263 residents; mean age: 37.55 years; males: 415 [63.6%]) were analyzed. The highest average number of m-EMR usage logs (897) was by medical residents, whereas the lowest (292) was by surgical residents. The usage amount for three menus, namely inpatient list (47,096), lab results (38,508), and investigation list (25,336), accounted for 60.1% of the peak time usage. The HIS was used most frequently during regular hours (9:00 AM to 5:00 PM). The peak usage time of the m-EMR was early in the morning (6:00 AM to 10:00 AM), and the use of the m-EMR from early evening (5:00 PM) to midnight was higher than during regular business hours. Four factors representing the types of clinical information were extracted through factor analysis. Factors related to patient investigation status and patient conditions were associated with the peak usage times of the m-EMR ( P<.01).

          Conclusions

          Access to information regarding patient investigation status and patient conditions is crucial for decision making during morning activities, including ward rounds. The m-EMRs allow doctors to maintain the continuity of their clinical information regardless of the time and location constraints. Thus, m-EMRs will best evolve in a manner that enhances the accessibility of clinical information helpful to the decision-making process under such constraints.

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          Most cited references35

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            TESTS OF SIGNIFICANCE IN FACTOR ANALYSIS

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              Health care professionals' use of mobile devices is transforming clinical practice. Numerous medical software applications can now help with tasks ranging from information and time management to clinical decision-making at the point of care.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                October 2017
                18 October 2017
                : 19
                : 10
                : e340
                Affiliations
                [1] 1 School of Management Engineering Korea Advanced Institute of Science and Technology (KAIST) Seoul Republic Of Korea
                [2] 2 Department of Biomedical Informatics Asan Medical Center University of Ulsan College of Medicine Seoul Republic Of Korea
                [3] 3 Carey Business School The Johns Hopkins University Baltimore, MD United States
                [4] 4 Medical Information Office Asan Medical Center Seoul Republic Of Korea
                [5] 5 Department of Emergency Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Republic Of Korea
                Author notes
                Corresponding Author: Jae-Ho Lee rufiji@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-4278-3491
                http://orcid.org/0000-0003-2048-3727
                http://orcid.org/0000-0002-0893-9712
                http://orcid.org/0000-0002-2338-9827
                http://orcid.org/0000-0003-2332-4940
                http://orcid.org/0000-0003-2619-1231
                Article
                v19i10e340
                10.2196/jmir.8128
                5666226
                29046269
                f0dd2858-eba5-4cf5-9f1e-7071a24c1a11
                ©Junetae Kim, Yura Lee, Sanghee Lim, Jeong Hoon Kim, Byungtae Lee, Jae-Ho Lee. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.10.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 1 June 2017
                : 12 July 2017
                : 18 August 2017
                : 30 August 2017
                Categories
                Original Paper
                Original Paper

                Medicine
                mobile health,electronic medical records,clinical information,rounding,timeliness,accessibility,smartphone

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