Is it possible for nurses and doctors to form a useful clinical overview of an EHR?

After implementation of an Electronic Health Record (EHR) at the hospital in Frederikshavn (Denmark) the doctors expressed that they had lost the overview of the information in the medical record and that it takes appreciably longer time to use the EHR. The future Electronic Health Records in Denmark will be structured according to the Fundamentals of the Danish Basic EHR Model, the "G-EPJ" Process Model. In addition, the model is interdisciplinary, problem oriented and based on clinical continuity. 16 clinicians from the hospital of Frederikshavn have joined in four focus-group interviews to clarify which information is used to form a clinical overview. The interviews have been analyzed methodically referring to Grounded Theory, and we have identified 8 factors which support the clinical overview, and besides that doctors and nurses form the clinical overview in different ways. Systematic information retrieval has been carried out to clarify how to optimize on-screen data presentation. Doctors, nurses and systems developers have worked together during 6 workshops, which has resulted in a set of screen images that support the nursing overview at the change of shift and the medical overview at ward rounds, respectively. The value of these screen images for the clinical overview has been tested in a real work situation at Roskilde Hospital, Denmark, in December 2005. And results show that the need for retrieving information from other documentation sources fell markedly when using an EHR instead of the usual paper-based record.