The physical attractiveness of electronic physician notes.

Though notes in electronic medical record systems (EMRs) have advantages, they are often criticized for their unattractive and unprofessional appearance. We sought to identify notes regarded by physicians as attractive and unattractive and the characteristics of both. We sent a sample of 10 notes representing a variety of common note types to a sample of 70 physicians who are either leaders in UW Medicine or randomly selected note authors and asked them to rank the notes by their physical attractivness. We found their rankings were not random, and notes clustered into those considered most, intermediate, and least attractive. Characteristics of each group are presented. We'll use these results to format EMR notes in a more attractive form-a goal important to our physicians-while preserving important clinical, quality and compliance features that were our original goals in moving to electronic notes.

Evolution and use of a note classification scheme in an electronic medical record.

Titles of clinical notes within an electronic medical record (EMR) are important because they influence the speed and completeness of the review of a patient's health record. We created a note classification scheme for notes in our EMR consisting of a 2 level hierarchy of note titles used to identify newly created and existing text and scanned notes. In a sample of 3 of the 18 months since beginning production use, an average of 2,810 notes are added each day. The number of distinct note titles rose by 32 percent between November 2003 and February 2005. Few changes were made to the upper level of the hierarchy. Thirty-three note titles accounted for 75% of the notes entered in February 2005. Note titles are one of several attributes that in conjunction with the user interface used to display them may affect the efficiency and completeness with which clinicians review their patient's records.

Creating a note classification scheme for a multi-institutional electronic medical record.

How notes are categorized in an electronic medical record (EMR) influences how rapidly users can locate documents and enter new ones, whether algorithmic search for chart deficiencies is possible, and the ease of incorporating collections of existing notes. We balanced these competing needs when developing a note classification scheme for the Online Record of Clinical Activity (ORCA) electronic medical record at the University of Washington.