Peripheral activities during EMR use in emergency care: a case study.

We report on how the use of electronic medical record (EMR) systems in an emergency department (ED) contributes to peripheral physician activities and in turn, how these peripheral activities can lead to challenges in the patient care process. Through a qualitative research study, we identify three prominent peripheral activities that affect the continuity of care: (1) transition between multiple artifacts, (2) movement between multiple locations and (3) transition of information between multiple care providers. We discuss how the peripheral activities can introduce new errors and create bottlenecks in patient flow, consequently affecting both clinical and organizational goals. We highlight the importance of integrating EMR applications with the model of practice in the ED.