From Visit to Visit: Information needs of primary care physicians providing continuity of care

This work analyzes the information needs of primary care physicians (PCPs) using paper and electronic medical records to provide continuity of care. PCPs accomplish continuity of care by following-up on health issues that have long-term trajectories over a series of visits. At a given visit, PCPs must identify on-going health issues and provide the care that is appropriate at the given point in the long-term trajectory of the health issue. Using ethnographic observation and interviews, I identify four types of information that primary care physicians use to plan what to work on with a patient during a visit: active problems, history of present illness, health maintenance history, and specific work items planned for the visit. I suggest that a unified view of these types of information would support primary care physicians to provide more efficient and effective continuity of care.