• Cecily Morrison, Matthew Jones, Alan Blackwell, and Alain Vuylsteke.
• Computer Laboratory, University of Cambridge, 15 JJ Thompson Avenue, Cambridge, CB3 0FD, UK. cpm38@cam.ac.uk
• Crit Care. 2008 Jan 1; 12 (6): R148.

IntroductionElectronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record.MethodsA qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews.ResultsOur analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions.ConclusionsWe discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.

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