1. Physician Shadowing: A first hand experience with an electronic medical record system (EMR-S) PJ Grier, MPA, MLS, AHIP Coordinator National Network of Libraries of Medicine Southeastern Atlantic Region University of Maryland Baltimore, MD Informatics for librarians 10/7/11NN/LM - SE/A

2. Background: The paper is comprised of observations that were extracted from physician shadowing exercises. The exercises supported informatics research conducted at the University of Maryland Medical System (UMMS) earlier this year. Informatics for librarians 10/7/11NN/LM - SE/A

3. Objectives: Physician Shadowing – tenets Potential to advance knowledge in health sciences librarianship Physicians’ HCI skills with Portfolio© Ambulatory A word about Portfolio© immersion Skills set for librarians Informatics for librarians NOTE: Portfolio© Ambulatory is a service mark of the University of Maryland Medical System for its EpicCare Electronic Medical Record system (EMR-S) 10/7/11NN/LM - SE/A

4. Physician Shadowing - tenets Informatics for librarians Is a tool for mentorship and learning – exposure to medicine’s “practical side” The student is bound by patient privacy and confidentiality. Usually a signed Agreement is executed. Patient must approve the shadowing before it occurs. Patients can say “NO.” Student interaction with the patient must be supervised by the physician at all times 10/7/11NN/LM - SE/A

5. PhysicianPhysician Shadowing: Form from Univ of Wash Informatics for librarians 10/7/11NN/LM - SE/A

6. Physician Shadowing: Potential to advance knowledge in health sciences librarianship Informatics for librarians iSchools - Health sciences librarianship certification student research iSchools – Faculty research Libraries – Aligned with teaching hospitals, medical schools or physician services Medical Library Association – independent research awards 10/7/11NN/LM - SE/A

7. Physicians’ HCI skills with EPIC Portfolio© Ambulatory Informatics for librarians Unintended consequences Patient mismatches Workflow impact Provider narrative 10/7/11NN/LM - SE/A

8. Portfolio© Ambulatory Immersion Informatics for librarians Research focus was on provider behaviour/interaction with EMR during patient encounter Eight (8) hours of classroom training – provider modules. EMR is an “interfaced “system, meaning connectivity to existing UMMS HIS. Example: patient tracking/scheduling is handled by a GE product. Access to Epic UserWeb Issued a provider med student PW/ID to one ambulatory clinic – a family practice office in West Baltimore 10/7/11NN/LM - SE/A

9. Skills set for librarians Info button Resolving system design/content representation issues Information retrieval Knowledge mapping Informatics for librarians 10/7/11NN/LM - SE/A

10. Readings: Kitsis EA. Shining a light on shadowing. JAMA. 2011 Mar 9;305(10) 1029-30 Horsky J, Allen MB, Wilcox AR, Pollard SE, Neri P, Pallin DJ, Rothschild JM. Analysis of user behavior in accessing electronic medical record systems in emergency departments. AMIA Annu Symp Proc. 2010 Nov 13;2010:311-5. Hernandez J, Al-Saadi S, Boyle R, Villadolid D, Ross S, Murr M, Rosemurgy A. Surgeons Can Favorably Influence Career Choices and Goals for Students Interested in Careers in Medicine Original Research Article. Journal of the American College of Surgeons, Volume 209, Issue 1, July 2009, Pages 62-67 Class (3CE): Informatics for Librarians: peeling the onion - http://nnlm.gov/sea/training/classes.html#A2 Informatics for librarians 10/7/11NN/LM - SE/A

11. QUESTIONS/COMMENTS: PJ Grier National Network of Libraries of Medicine pgrier@hshsl.umaryland.edu 410.706.2855 pgrier@hshsl.umaryland.edu Informatics for librarians 10/7/11NN/LM - SE/A