The essence of healthcare records: embedded electronic health record system microblogging functionality for patient care narrative.

INTRODUCTION: Electronic health record (EHR) systems capture information relating to patients across many specialties but can be complex, making rapid evaluation and communication of current important issues difficult. METHODS: As part of a children's hospital EHR implementation, we developed and implemented an embedded microblogging platform to allow users to provide a short summary of main issues or actions relating to the encounter, 'Essence' capturing the essence of the interaction. We reviewed usage by specialty and user type over a 1-year period. RESULTS: Ninety-one thousand, nine-hundred and fifty Essence entries were committed across 49 specialty areas during a 12-month period, April 2019 - April 2020. The specialties with greatest usage were cardiology, neurosurgery, intensive care, respiratory medicine and neurology, with 70% of entries by nursing staff. The median number of words used per entry was 17 words (range 1-120; mean 20.7), and microblogs were mainly used to describe actions, events or planned care. Manual content analysis of 200 representative entries demonstrated categories of importance (including clinical status, treatment plan, investigations, procedures and diagnoses) suggesting appropriate clinical utility. CONCLUSION: Incorporation of an embedded EHR microblogging platform to capture key interactions with healthcare professionals represents a novel approach to coordinating care communication and is widely used across specialties, especially by nursing staff.

How can we help witnesses to remember more? It's an (eyes) open and shut case.

Five experiments tested the idea that instructing a witness to close their eyes during retrieval might increase retrieval success. In Experiment 1 participants watched a video, before a cued-recall test for which they were either instructed to close their eyes, or received no-instructions. Eye-closure led to an increase in correct cued-recall, with no increase in incorrect responses. Experiments 2-5 sought to test the generality of this effect over variations in study material (video or live interaction), test format (cued- or free-recall) and information modality (visual or auditory details recalled). Overall, eye-closure increased recall of both visual detail and auditory details, with no accompanying increase in recall of false details. Collectively, these data convincingly demonstrate the benefits of eye-closure as an aid to retrieval, and offer insight into why hypnosis, which usually involves eye-closure, may facilitate eyewitness recall.