One Size Does Not Fit All: EHR Clinical Summary Design Requirements for Nurses.

Research has established the pivotal role of cognitive artifacts to human information visualization, the reduction of memory load, and critical thinking. A long-standing nursing practice is the development of a personal cognitive artifact that summarizes the clinical condition and plan of care for the patient(s) in the care of the nurse. Distributed cognition establishes the importance of the role of cognitive artifacts to the cognition of each individual. A feature/function of electronic health record applications is to supply a real-time clinical overview of a patient's clinical condition and care needs, which is often referenced as a patient clinical summary. Research regarding the requirements of electronic clinical summaries to support clinician cognition has not been reported to date. This paper reports the results of initial research to establish foundational principles for the development of EHR patient clinical summaries that support the cognition and critical thinking of the registered nurse.