“Electronic health records’ support for primary care physicians’ situation awareness: Metanarrative review” is published online ahead of print in Human Factors, the Journal of the Human Factors and Ergonomics Society. Authors, in addition to Dr. Savoy, are Himalaya Patel, PhD; Daniel R. Murphy, M.D., MBA; Ashley N.D. Meyer, PhD; Jennifer Herout, PhD; Hardeep Singh, M.D., MPH, all with the VA. The study was funded by the Human Factors Engineering Directorate in the Office of Health Informatics, U.S. Department of Veterans Affairs (VA).

To understand the extent to which EHRs support primary care physicians, the authors reviewed and analyzed studies describing EHR workflow misalignments, usability issues and communication challenges. Significant difficulties were reported related to obtaining clinical information from EHRs. Lab results and care plans were often incomplete, untimely or irrelevant. The study also included review of common clinical decisions and tasks related to care management of adult patients that are typically not supported by clinical decision support tools such as whether to start palliative care, predicting quality of life and recovery time, and tracking progress toward patients’ stated goals.


The authors conducted a metanarrative analysis which is more inclusive and open ended than a metanalysis. They found that primary care physicians’ experiences using EHRs often included redundant interaction and information overload, which they note could be remediated by incorporating user-centered design principles into future EHR design, development and evaluation.

About Richard L. Roudebush Veterans Affairs (VA) Medical Center
Established in 1932, the Richard L. Roudebush VA Medical Center serves Veterans from across Indiana and western Illinois. The Roudebush VAMC is one of the largest and most complex medical centers in the Department of Veterans Affairs, and provides acute inpatient medical, surgical, psychiatric, rehabilitation, and neurological care to more than 60,000 Veterans annually. Some of the many services available to Veterans include emergency medicine, primary care, cardiac care, radiation oncology, audiology, community-based extended care and community VA clinics.


About Regenstrief Institute
Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform practice and improve the lives of patients around the globe. 

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