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Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff

Cecily Morrison1, Matthew Jones2, Alan Blackwell1 and Alain Vuylsteke3*

Author Affiliations

1 Computer Laboratory, University of Cambridge, 15 JJ Thompson Avenue, Cambridge, CB3 0FD, UK

2 Judge Business School, University of Cambridge, Trumpington Street, Cambridge, CB2 1AG, UK

3 Papworth Hospital, NHS Foundation Trust, Cambridge, CB23 3RE, UK

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Critical Care 2008, 12:R148  doi:10.1186/cc7134

See related commentary by Lapinsky,

Published: 24 November 2008



Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record.


A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews.


Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions.


We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.