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The online version of this article (doi:10.1186/1472-6947-12-127) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
CH created the questionnaire, conducted interviews, collected online responses, transcribed and analyzed the data, and drafted the manuscript. MB participated in designing the study and drafting of the manuscript. DS participated in the review and redrafting process. AW participated in the design and coordination of the study, recruitment of respondents, data analysis, and drafting of the manuscript. All authors read and approved the final manuscript.
The problem list is a key part of the electronic health record (EHR) that allows practitioners to see a patient’s diagnoses and health issues. Yet, as the content of the problem list largely represents the subjective decisions of those who edit it, patients’ problem lists are often unreliable when shared across practitioners. The lack of standards for how the problem list is compiled in the EHR limits its effectiveness in improving patient care, particularly as a resource for clinical decision support and population management tools. The purpose of this study is to discover practitioner opinions towards the problem list and the logic behind their decisions during clinical situations.
Materials and methods
An observational cross-sectional study was conducted at two major Boston teaching hospitals. Practitioners’ opinions about the problem list were collected through both in-person interviews and an online questionnaire. Questions were framed using vignettes of clinical scenarios asking practitioners about their preferred actions towards the problem list.
These data confirmed prior research that practitioners differ in their opinions over managing the problem list, but in most responses to a questionnaire, there was a common approach among the relative majority of respondents. Further, basic demographic characteristics of providers (age, medical experience, etc.) did not appear to strongly affect attitudes towards the problem list.
The results supported the premise that policies and EHR tools are needed to bring about a common approach. Further, the findings helped identify what issues might benefit the most from a defined policy and the level of restriction a problem list policy should place on the addition of different types of information.