Impact of document consolidation on healthcare providers' perceived workload and information reconciliation tasks: a mixed methods study

Masoud Hosseini, Anthony Faiola, Josette Jones, Daniel J. Vreeman, Huanmei Wu, Brian E. Dixon

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Information reconciliation is a common yet complex and often time-consuming task performed by healthcare providers. While electronic health record systems can receive outside information about a patient in electronic documents, rarely does the computer automate reconciling information about a patient across all documents. Materials and Methods: Using a mixed methods design, we evaluated an information system designed to reconcile information across multiple electronic documents containing health records for a patient received from a health information exchange (HIE) network. Nine healthcare providers participated in scenario-based sessions in which they manually consolidated information across multiple documents. Accuracy of consolidation was measured along with the time spent completing 3 different reconciliation scenarios with and without support from the information system. Participants also attended an interview about their experience. Perceived workload was evaluated quantitatively using the NASA-TLX tool. Qualitative analysis focused on providers' impression of the system and the challenges faced when reconciling information in practice. Results: While 5 providers made mistakes when trying to manually reconcile information across multiple documents, no participants made a mistake when the system supported their work. Overall perceived workload decreased significantly for scenarios supported by the system (37.2% in referrals, 18.4% in medications, and 31.5% in problems scenarios, P0.001). Information reconciliation time was reduced significantly when the system supported provider tasks (58.8% in referrals, 38.1% in medications, and 65.1% in problem scenarios). Conclusion: Automating retrieval and reconciliation of information across multiple electronic documents shows promise for reducing healthcare providers' task complexity and workload.

Original languageEnglish
Pages (from-to)134-142
Number of pages9
JournalJournal of the American Medical Informatics Association
Issue number2
StatePublished - Feb 1 2019

Bibliographical note

Publisher Copyright:
Copyright © 2019 Schizophrenia Bulletin. All rights reserved.


  • Clinical Document Architecture (CDA)
  • Consolidation
  • Continuity of Care Document (CCD)
  • De-duplication
  • Health Information Exchange (HIE)
  • Health Level Seven (HL7)
  • Meaningful use
  • Workload

ASJC Scopus subject areas

  • Health Informatics


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