Appl Clin Inform 2011; 02(02): 190-201
DOI: 10.4338/ACI-2011-02-RA-0011
Research Article – MedInfo Special Topic
Schattauer GmbH

Clinician preferences for verbal communication compared to EHR documentation in the ICU

S.A. Collins
1   Department of Biomedical Informatics, Columbia University
S. Bakken
1   Department of Biomedical Informatics, Columbia University
2   School of Nursing, Columbia University
D.K. Vawdrey
1   Department of Biomedical Informatics, Columbia University
E. Coiera
3   Centre for Health Informatics, University of New South Wales
L. Currie
4   School of Nursing, University of British Columbia
› Author Affiliations
This project was supported by the National Institute for Nursing Research T32NR007969 and by Wireless Informatics for Safe and Evidence-based APN Care (D11 HP07346). Dr. Collins is supported by T15 LM 007079.
Further Information

Publication History

Received: 04 February 2011

Accepted: 22 April 2011

Publication Date:
16 December 2017 (online)


Background: Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information exchange and communication.

Objective: We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks.

Methods: We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds.

Results: Clinicians used an EHR system, which included electronic documentation and computerized provider order entry (CPOE), and paper artifacts for documentation; yet, preferred the verbal communication space as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the EHR is a “shift behind” may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss.

Conclusions: Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.