{"id":"https://openalex.org/W3200169169","doi":"https://doi.org/10.1055/s-0041-1735257","title":"An Analysis of Electronic Health Record Work to Manage Asynchronous Clinical Messages among Breast Cancer Care Teams","display_name":"An Analysis of Electronic Health Record Work to Manage Asynchronous Clinical Messages among Breast Cancer Care Teams","publication_year":2021,"publication_date":"2021-08-01","ids":{"openalex":"https://openalex.org/W3200169169","doi":"https://doi.org/10.1055/s-0041-1735257","mag":"3200169169","pmid":"https://pubmed.ncbi.nlm.nih.gov/34528233"},"language":"en","primary_location":{"id":"doi:10.1055/s-0041-1735257","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0041-1735257","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1735257.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1735257.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5082251203","display_name":"Bryan D. Steitz","orcid":"https://orcid.org/0000-0003-2066-8692"},"institutions":[{"id":"https://openalex.org/I200719446","display_name":"Vanderbilt University","ror":"https://ror.org/02vm5rt34","country_code":"US","type":"education","lineage":["https://openalex.org/I200719446"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Bryan D. Steitz","raw_affiliation_strings":["Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States","institution_ids":["https://openalex.org/I200719446"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083860679","display_name":"Kim M. Unertl","orcid":"https://orcid.org/0000-0003-0094-3677"},"institutions":[{"id":"https://openalex.org/I200719446","display_name":"Vanderbilt University","ror":"https://ror.org/02vm5rt34","country_code":"US","type":"education","lineage":["https://openalex.org/I200719446"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kim M. Unertl","raw_affiliation_strings":["Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States","institution_ids":["https://openalex.org/I200719446"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5030770357","display_name":"Mia Levy","orcid":"https://orcid.org/0000-0002-5944-2730"},"institutions":[{"id":"https://openalex.org/I200719446","display_name":"Vanderbilt University","ror":"https://ror.org/02vm5rt34","country_code":"US","type":"education","lineage":["https://openalex.org/I200719446"]},{"id":"https://openalex.org/I49886154","display_name":"Rush University","ror":"https://ror.org/01k9xac83","country_code":"US","type":"education","lineage":["https://openalex.org/I49886154"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mia A. Levy","raw_affiliation_strings":["Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States","Division Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University School of Medicine, Chicago, Illinois, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States","institution_ids":["https://openalex.org/I200719446"]},{"raw_affiliation_string":"Division Hematology, Oncology and Cell Therapy, Department of Medicine, Rush University School of Medicine, Chicago, Illinois, United States","institution_ids":["https://openalex.org/I49886154"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":2.5147,"has_fulltext":true,"cited_by_count":13,"citation_normalized_percentile":{"value":0.91007912,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":98},"biblio":{"volume":"12","issue":"04","first_page":"877","last_page":"887"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.3091000020503998,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.3091000020503998,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10178","display_name":"Cancer survivorship and care","score":0.155799999833107,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12174","display_name":"Hospital Admissions and Outcomes","score":0.07069999724626541,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/audit","display_name":"Audit","score":0.5615301728248596},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.5491420030593872},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.5267466902732849},{"id":"https://openalex.org/keywords/asynchronous-communication","display_name":"Asynchronous communication","score":0.5207316875457764},{"id":"https://openalex.org/keywords/breast-cancer","display_name":"Breast cancer","score":0.5054550170898438},{"id":"https://openalex.org/keywords/medical-record","display_name":"Medical record","score":0.42062121629714966},{"id":"https://openalex.org/keywords/family-medicine","display_name":"Family medicine","score":0.3563620150089264},{"id":"https://openalex.org/keywords/medical-emergency","display_name":"Medical emergency","score":0.32718950510025024},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.31713974475860596},{"id":"https://openalex.org/keywords/cancer","display_name":"Cancer","score":0.23688584566116333},{"id":"https://openalex.org/keywords/internal-medicine","display_name":"Internal medicine","score":0.1000591516494751},{"id":"https://openalex.org/keywords/business","display_name":"Business","score":0.09787401556968689}],"concepts":[{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.5615301728248596},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5491420030593872},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5267466902732849},{"id":"https://openalex.org/C151319957","wikidata":"https://www.wikidata.org/wiki/Q752739","display_name":"Asynchronous communication","level":2,"score":0.5207316875457764},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.5054550170898438},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.42062121629714966},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3563620150089264},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.32718950510025024},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.31713974475860596},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.23688584566116333},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.1000591516494751},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.09787401556968689},{"id":"https://openalex.org/C31258907","wikidata":"https://www.wikidata.org/wiki/Q1301371","display_name":"Computer network","level":1,"score":0.0},{"id":"https://openalex.org/C121955636","wikidata":"https://www.wikidata.org/wiki/Q4116214","display_name":"Accounting","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D001943","descriptor_name":"Breast Neoplasms","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D001943","descriptor_name":"Breast Neoplasms","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D001943","descriptor_name":"Breast Neoplasms","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D003142","descriptor_name":"Communication","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003142","descriptor_name":"Communication","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003142","descriptor_name":"Communication","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009042","descriptor_name":"Motivation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009042","descriptor_name":"Motivation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009042","descriptor_name":"Motivation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010348","descriptor_name":"Patient Care Team","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010348","descriptor_name":"Patient Care Team","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010348","descriptor_name":"Patient Care Team","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1055/s-0041-1735257","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0041-1735257","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1735257.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},{"id":"pmid:34528233","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/34528233","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied clinical informatics","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:8443401","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8443401","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Appl Clin Inform","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1055/s-0041-1735257","is_oa":true,"landing_page_url":"https://doi.org/10.1055/s-0041-1735257","pdf_url":"http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0041-1735257.pdf","source":{"id":"https://openalex.org/S187139995","display_name":"Applied Clinical Informatics","issn_l":"1869-0327","issn":["1869-0327"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320000","host_organization_name":"Thieme Medical Publishers (Germany)","host_organization_lineage":["https://openalex.org/P4310320000"],"host_organization_lineage_names":["Thieme Medical Publishers (Germany)"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Applied Clinical Informatics","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[{"id":"https://openalex.org/G1612602199","display_name":null,"funder_award_id":"T15 LM007450","funder_id":"https://openalex.org/F4320337372","funder_display_name":"U.S. National Library of Medicine"},{"id":"https://openalex.org/G5135383786","display_name":null,"funder_award_id":"4T15LM007450","funder_id":"https://openalex.org/F4320337372","funder_display_name":"U.S. National Library of Medicine"}],"funders":[{"id":"https://openalex.org/F4320337372","display_name":"U.S. National Library of Medicine","ror":"https://ror.org/0060t0j89"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W3200169169.pdf","grobid_xml":"https://content.openalex.org/works/W3200169169.grobid-xml"},"referenced_works_count":56,"referenced_works":["https://openalex.org/W12948169","https://openalex.org/W19016600","https://openalex.org/W86958088","https://openalex.org/W152097917","https://openalex.org/W280452506","https://openalex.org/W1969817931","https://openalex.org/W1983633105","https://openalex.org/W2035038570","https://openalex.org/W2063413877","https://openalex.org/W2088104902","https://openalex.org/W2094561838","https://openalex.org/W2095293504","https://openalex.org/W2102705332","https://openalex.org/W2119200560","https://openalex.org/W2119517687","https://openalex.org/W2120411377","https://openalex.org/W2124518690","https://openalex.org/W2137061453","https://openalex.org/W2145573787","https://openalex.org/W2181417294","https://openalex.org/W2246213430","https://openalex.org/W2331705398","https://openalex.org/W2355181225","https://openalex.org/W2417370979","https://openalex.org/W2434099711","https://openalex.org/W2468628434","https://openalex.org/W2516936793","https://openalex.org/W2569677127","https://openalex.org/W2606911374","https://openalex.org/W2617070908","https://openalex.org/W2618635343","https://openalex.org/W2621145851","https://openalex.org/W2728189178","https://openalex.org/W2753001088","https://openalex.org/W2753519309","https://openalex.org/W2754518417","https://openalex.org/W2768797527","https://openalex.org/W2783278280","https://openalex.org/W2794867331","https://openalex.org/W2804394016","https://openalex.org/W2808333563","https://openalex.org/W2884265062","https://openalex.org/W2901330484","https://openalex.org/W2902257721","https://openalex.org/W2944454852","https://openalex.org/W2954484941","https://openalex.org/W2973662052","https://openalex.org/W2985098224","https://openalex.org/W2996946491","https://openalex.org/W2999645127","https://openalex.org/W3004652223","https://openalex.org/W3005890082","https://openalex.org/W3006426907","https://openalex.org/W3025472689","https://openalex.org/W3124239125","https://openalex.org/W6606106347"],"related_works":["https://openalex.org/W2116677773","https://openalex.org/W2155261584","https://openalex.org/W2584231425","https://openalex.org/W2042919702","https://openalex.org/W2150611273","https://openalex.org/W4207086172","https://openalex.org/W4225981436","https://openalex.org/W2156185805","https://openalex.org/W2770353918","https://openalex.org/W2122502560"],"abstract_inverted_index":{"OBJECTIVE:":[0],"Asynchronous":[1],"messaging":[2,58,134,149,184,202],"is":[3,221],"an":[4,156,187],"integral":[5],"aspect":[6],"of":[7,23,53,89,96,111,117,138,158,189,206,218,234],"communication":[8,41,236],"in":[9,68,80,136,186,204],"clinical":[10,179,201,219],"settings,":[11],"but":[12],"imposes":[13],"additional":[14],"work":[15,233],"and":[16,56,225],"potentially":[17],"leads":[18],"to":[19,27,38,42,223,244,248],"inefficiency.":[20],"The":[21],"goal":[22],"this":[24],"study":[25],"was":[26],"describe":[28],"the":[29,33,61,101,105,115,172,231,242],"time":[30],"spent":[31],"using":[32],"electronic":[34,232],"health":[35],"record":[36],"(EHR)":[37],"manage":[39],"asynchronous":[40,235],"support":[43],"breast":[44,69],"cancer":[45,70,129,173],"care":[46,64,71,130,227,238],"coordination.":[47],"METHODS:":[48],"We":[49],"analyzed":[50],"3":[51],"years":[52],"audit":[54],"logs":[55,59],"secure":[57],"from":[60],"EHR":[62,81,140,208],"for":[63],"team":[65,131,239],"members":[66,132,240],"involved":[67],"at":[72],"Vanderbilt":[73],"University":[74],"Medical":[75],"Center.":[76],"To":[77],"evaluate":[78],"trends":[79],"use,":[82],"we":[83],"combined":[84],"log":[85],"data":[86],"into":[87],"sequences":[88],"events":[90],"that":[91],"occurred":[92,203],"within":[93],"15":[94,190],"minutes":[95,164],"any":[97],"other":[98],"event":[99],"by":[100,121],"same":[102,106],"employee":[103,250],"about":[104],"patient.":[107],"RESULTS:":[108],"Our":[109],"cohort":[110],"9,761":[112],"patients":[113],"were":[114],"subject":[116],"430,857":[118],"message":[119],"threads":[120],"7,194":[122],"employees":[123],"over":[124],"a":[125,215],"3-year":[126],"period.":[127],"Breast":[128],"performed":[133,183],"actions":[135,185],"37.5%":[137],"all":[139,207],"sessions,":[141],"averaging":[142],"29.8":[143],"(standard":[144],"deviation":[145],"[SD]":[146],"=":[147,192],"23.5)":[148],"sessions":[150,154,194],"per":[151,195],"day.":[152,196],"Messaging":[153],"lasted":[155],"average":[157,188],"1.1":[159],"(95%":[160],"confidence":[161],"interval:":[162],"0.99-1.24)":[163],"longer":[165],"than":[166],"nonmessaging":[167],"sessions.":[168,209],"On":[169],"days":[170],"when":[171],"providers":[174],"did":[175],"not":[176],"otherwise":[177],"have":[178],"responsibilities,":[180],"they":[181],"still":[182],"(SD":[191],"11.9)":[193],"CONCLUSION:":[197],"At":[198],"our":[199],"institution,":[200],"35%":[205],"Clinical":[210],"messaging,":[211],"sometimes":[212],"viewed":[213],"as":[214],"supporting":[216],"task":[217],"work,":[220],"important":[222],"delivering":[224],"coordinating":[226],"across":[228],"roles.":[229],"Measuring":[230],"among":[237],"affords":[241],"opportunity":[243],"systematically":[245],"identify":[246],"opportunities":[247],"improve":[249],"workload.":[251]},"counts_by_year":[{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":3},{"year":2023,"cited_by_count":4},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":1}],"updated_date":"2026-07-01T08:55:40.977307","created_date":"2025-10-10T00:00:00"}
