SHM Converge Scientific Abstract ePoster Gallery-Use of Problem Lists in Hospital Medicine

Pdf Summary

This study examined how hospital clinicians use the electronic health record (EHR) problem list at Brigham and Women’s Hospital and what affects its adoption. Problem lists are intended to give clinicians a concise, central view of a patient’s active medical problems. They can improve chart review, streamline documentation and billing, support communication between inpatient and outpatient teams, reduce errors from missing information, and help research data collection. However, their use remains inconsistent.<br /><br />The researchers surveyed attendings, advanced practice providers (APPs), and internal medicine residents using REDCap, then analyzed responses quantitatively and qualitatively. Of 185 clinicians surveyed, 102 responded. Respondents were evenly split by gender, with half attendings, about 23% APPs, and 27% residents.<br /><br />Results showed substantial variation in use. More than half of respondents said they never or rarely edited the hospital problem list. Among those who did use it, most edited it at admission. APPs were the most consistent users, while residents were least likely to actively manage the list and often preferred free-text documentation.<br /><br />The main perceived benefits were helping identify or manage chronic conditions and auto-populating progress note templates. The biggest barriers were poor usability, lack of time, and outdated problem lists. Clinicians suggested that better EHR design, such as fewer clicks and drag-and-drop functionality, clearer training and usage guidelines, and more consistent expectations across inpatient and outpatient settings could improve adoption.<br /><br />Overall, the study found that while EHR-based hospital problem lists have clear advantages, their use is limited by workflow and usability issues. Standardized institutional practices and improved interfaces could increase consistent use and potentially improve documentation quality and patient safety.

Asset Subtitle

Abhishek Goyal

Meta Tag

Author List Abhishek Goyal, Alison Garber, Anuj K. Dalal

Category Research

Concept EHR-Based Hospital Problem List

Concept Patient Safety

Concept Problem List Use

Concept Patient Care

Concept Documentation

Distinguished Non-Finalist

Presenter Organization Brigham & Women's Hospital, Harvard Medical School

Presenting Author Abhishek Goyal

Track Technology in Hospital Medicine

Keywords

electronic health record

EHR problem list

hospital clinicians

adoption barriers

workflow usability

Brigham and Women’s Hospital

documentation quality

patient safety

internal medicine residents

advanced practice providers

EHR-Based Hospital Problem List

Patient Safety

Problem List Use

Patient Care

Documentation