Project 3 - Inside the Black Box of Clinical Decision-Making: Provider Practice Habits, Provider Caseloads, and Implications for Patients with ADRD

The process of arriving at a clinical decision in Emergency Department settings is influenced by a complex set of factors, some of which are hard to observe in analytic databases, including those based on administrative records. These factors encompass not just the biomedical, but also the clinical environment, patient conditions and characteristics, team interactions, clinician fatigue and stress, and information flow. These supplementary, often unobserved, and more subtle factors may be especially influential for patients with ADRD, who present unique challenges of diagnosis and care management. This project delves into these wider influences by analyzing unique, high frequency audit log data on providers’ use of the Electronic Health Records (EHR) system at a major hospital Emergency Department. The data are used to drill down on the process of diagnosis and treatment decision-making, and how it is influenced by the health profiles and needs of patient with different characteristics, including ADRD, as well as differences in provider type, level, and the complex demands providers face in servicing Emergency Department patients.