Understanding and addressing challenges with Electronic Health Record use in gynaecological oncology: a cross-sectional survey of multidisciplinary professionals in the United Kingdom and co-design of an integrated informatics platform to support clinical decision making. (Preprint)

BACKGROUND The benefits and challenges of Electronic Health Record (EHR) use may be particularly significant in complex, high-risk specialties such as gynaecological oncology, yet few studies address the experiences of end-users. OBJECTIVE This study aimed to explore perspectives on EHR use in gynaecological oncology and to develop an informatics platform for ovarian cancer. METHODS A cross-sectional survey was conducted using a web-based questionnaire to capture UK professional experiences of EHR use. Free-text responses were analysed using content analysis; counts and proportions were calculated for quantitative data. An informatics platform was co-designed using human-centred design. Natural language processing was used to extract genomic results and operative details from free-text documentation. RESULTS Of 92 respondents, 84 (92.3%) access multiple electronic systems for clinical decision-making, with 28.6% (26/91) using ≥5 EHR systems. Around 17% (16/92) spend more than 50% of their clinical time looking for information in the EHR. Key challenges relate to fragmentation of the patient record across disparate systems meaning retrieval of pertinent information is often time-consuming. The main benefit of EHR use was perceived to be ease-of-access to patient information, yet 60.0% (54/90) of respondents do not have access to individual patient summaries. Our co-designed ovarian cancer informatics platform brings together patient data from different electronic systems and displays it in a single location to support clinical decision making. CONCLUSIONS EHR systems are not currently optimised to support decision-making in gynae-oncology. Co-designed clinical decision support tools could address challenges with data fragmentation and information retrieval towards improvements in the quality and safety of cancer care.