Table 1 Summary of themes
From: Clinician attitudes toward and use of electronic problem lists: a thematic analysis
Theme | Aspects and Interconnections |
|---|---|
Workflow | • Aspects |
   ○ Points in the clinical encounter where providers use the problem list | |
   ○ Usability issues | |
   ○ Delegation of problem list use | |
• Interconnections | |
   ○ Delegation often depended on attitudes towards ownership and responsibility | |
   ○ Different workflows appeared depending on uses | |
Ownership and Responsibility | • Aspects |
   ○ Issues regarding what providers are responsible for maintaining the problem list, and which problems each provider is responsible for | |
• Interconnections | |
   ○ Providers felt more ownership when they saw relevance to their practice | |
Relevance | • Aspects |
   ○ The extent to which providers viewed the problem list as relevant to their practice | |
   ○ Includes both intrinsic and extrinsic relevance (including authority) | |
• Interconnections | |
   ○ Relevance drives use and sense of ownership/responsibility | |
Uses | • Aspects |
   ○ All reported uses of the problem list by providers | |
   ○ Included both adding problems and referring to problems, as well as non-clinical uses (billing, etc.) | |
• Interconnections | |
   ○ Perceived uses drive relevance | |
   ○ Different uses often require different workflow | |
Content | • Aspects |
   ○ Concepts relating to provider opinions on appropriate (and inappropriate) types of problem list content | |
• Interconnections | |
   ○ Content relates to relevance, as providers are most interested in adding content they perceive to be relevant | |
   ○ Provider attitudes towards ownership and responsibility affect their willingness to modify problem list content (e.g. to discontinue a problem added by another provider that they consider irrelevant or incorrect) | |
Presentation | • Aspects |
   ○ Observations related to actual and ideal representation of information in the problem list tool | |
• Interconnections | |
   ○ Different workflows and uses may have different optimal presentations | |
Accuracy | • Aspects |
   ○ Observations and opinions relating to the general accuracy, completeness and currency of patient problem lists | |
• Interconnections | |
   ○ Perceptions of accuracy affect uses and intention to use | |
Alternatives | • Aspects |
   ○ Any other mechanism of documenting problem list content other than the formal structured problem list | |
• Interconnections | |
   ○ Perception that alternatives are superior affects use and relevance attitudes | |
Support/Education | • Aspects |
   ○ Observations related to education and technical training on problem list use and ongoing support | |
• Interconnections | |
   ○ Support/education affect perception of uses and relevance | |
   ○ Issues with workflow relate to sub-optimal support/education | |
Culture | • Aspects |
   ○ Local, institutional and professional culture around problem list use | |
• Interconnections | |
   ○ Cross-cutting theme influencing all other themes |