Electronic Medical Records, Provider Behavior and Health Outcomes among the Elderly

Our project uses innovative, granular Electronic Medical Record (EMR) data from the UCSF medical system to study health care and health outcomes for the elderly. A central theme of our project is to leverage these data to develop an in-depth understanding of information acquisition, transmission and use in clinical decisions. Understanding this process can help us assess quality of care as well as develop next generation systems to improve the ways in which physicians and other clinical staff practice medicine with the help of electronic systems. These insights have particularly bearing on our understanding of treatment for the elderly since, on average, they are complex patients who have been assessed and received treatments over long time periods.
The digitization of health records and the metadata captured by these systems create a novel and exciting opportunity to rapidly advance both our understanding of biases and heuristics in clinical decision-making, and our understanding of how to design clinical decision support tools to overcome them. Specifically, the ability to truly understand how frontline clinicians interact with clinical information when making decisions, and how these interactions impact clinical care and health outcomes, requires analysis of a largely-unused, highly-granular level of electronic health record (EHR) data (referred to as “clickstream” or “audit log” data) that are captured primarily for administrative compliance purposes today.