Understanding and addressing challenges with Electronic Health Record use in gynaecological oncology: a cross-sectional survey of multidisciplinary professionals in the United Kingdom and co-design of an integrated informatics platform to support clinical decision making. (Preprint)

Abstract

BACKGROUND The benefits and challenges of Electronic Health Record (EHR) use may be particularly significant in complex, high-risk specialties such as gynaecological oncology, yet few studies address the experiences of end-users. OBJECTIVE This study aimed to explore perspectives on EHR use in gynaecological oncology and to develop an informatics platform for ovarian cancer. METHODS A cross-sectional survey was conducted using a web-based questionnaire to capture UK professional experiences of EHR use. Free-text responses were analysed using content analysis; counts and proportions were calculated for quantitative data. An informatics platform was co-designed using human-centred design. Natural language processing was used to extract genomic results and operative details from free-text documentation. RESULTS Of 92 respondents, 84 (92.3%) access multiple electronic systems for clinical decision-making, with 28.6% (26/91) using ≥5 EHR systems. Around 17% (16/92) spend more than 50% of their clinical time looking for information in the EHR. Key challenges relate to fragmentation of the patient record across disparate systems meaning retrieval of pertinent information is often time-consuming. The main benefit of EHR use was perceived to be ease-of-access to patient information, yet 60.0% (54/90) of respondents do not have access to individual patient summaries. Our co-designed ovarian cancer informatics platform brings together patient data from different electronic systems and displays it in a single location to support clinical decision making. CONCLUSIONS EHR systems are not currently optimised to support decision-making in gynae-oncology. Co-designed clinical decision support tools could address challenges with data fragmentation and information retrieval towards improvements in the quality and safety of cancer care.