CCE Theses and Dissertations

Date of Award

2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Information Systems (DISS)

Department

College of Computing and Engineering

Advisor

Laurie Dringus

Committee Member

Ling Wang

Committee Member

Elizabeth Arceneaux

Keywords

EHR, electronic health record, health informatics, health information technology (IT), human-computer interaction, user flow

Abstract

way patient information is stored, managed, and accessed. This transition to Electronic Health Record (EHR) systems has enhanced the efficiency and accuracy of healthcare delivery by enabling quick access to patient records, reduction of errors, and facilitation of coordination among healthcare providers. In the EHR system, diverse tasks are performed for clinical processes and patient care. These tasks can be considered simple or complex, ranging from documenting patient visits and updating medical histories to ordering tests and managing prescriptions. Although EHR systems have become more prevalent in their use, there are noted challenges associated with the design of the system that can affect a physician’s workflow and productivity.

Previous studies have investigated the user experience (UX) pain points of physicians utilizing the EHR system; however, research is limited in understanding the specific task complexities of workflows that assist specialized healthcare units. Although research has identified some notable issues with task complexity and system usage, there is a lack of qualitative research that explores the user experiences of pediatric physicians and their workflow processes. An Applied Cognitive Task Analysis (ACTA) method was performed with the goal to explore the nature of pediatric physician’s user experiences and challenges with EHRs, with a focus on documentation and historical chart review. This method included examining specific actions, decisions, and problem-solving techniques physician participants employ during their interactions with the EHR system to help identify potential cognitive demands and UX pain points that they encounter. The overarching research question was: What major tasks do pediatric physicians describe as complex or difficult to navigate through the numerous task flows they perform with the EHR system? Sub-questions were used to facilitate aspects of this grand tour question.

Five pediatric physician participants were recruited from one clinic located in South Florida. The data collected from semi-structured interviews and completions of task flow scenarios was analyzed and reviewed to identify common themes and sub-themes related to task complexities of EHR systems. The five super-ordinate themes developed from the interviews: Difficult Use of SOAP Documentation Tool, Difficult Identification of Well and Sick Visits, Inadequate Use of Templates, Poor Organization of Clinical Data, and Difficulty with Ordering in the Assessment and Plan Section. The findings uncover connections with previous research that explored physicians’ experiences with the complex EHR system due to information overload, task complexity, mental demand, and inefficient user interface design. The study provides future research opportunities to examine additional processes and tasks performed by physician users, as well as to investigate physicians working in other specialized healthcare settings, such as the neonatal intensive care unit (NICU).

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