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Dissecting the Pre-Handoff Chart Biopsy: Information Seeking in the Electronic Health Record

Brian Hilligoss

(Submission #167)


Abstract

Pre-handoff chart biopsy involves the brief reviewing by a clinician of a patient’s record prior to accepting responsibility for the care of that patient. It is an information seeking activity enabled by electronic health records. This paper reports on a qualitative study of chart biopsies conducted by General Medicine physicians in a large quaternary teaching hospital prior to receiving responsibility for patients newly admitted from the Emergency Department (ED). The paper characterizes an information practice not previously documented and demonstrates how chart biopsies contribute to the understandings physicians construct of patients and of the work of other physicians. Findings show how physicians use different parts of the record to make inferences about patients, develop a sense of the patient’s illness trajectory, and assess the disposition plans of ED staff. Chart biopsies are often guided by specific questions, but the act of doing a chart biopsy may itself produce questions in the minds of physicians. The negotiations that constitute organizational change and stability may be influenced by the information practice of doing a chart biopsy.

Categories

Program Track:  Track 1 - Information Behaviour
Submission Type:  Research Paper

 


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