Strategies and Tools for Electronic Health Records and Physician Workflow Alignment: Protocol for a Scoping Review

Abstract

BACKGROUND: Electronic health records (EHRs) have been widely adopted in health care systems globally, offering potential benefits in data accessibility, quality improvement, and enhanced patient outcomes. However, the alignment between EHRs and physician workflows remains a significant challenge, leading to negative impacts on physician well-being and patient care. While health care organizations have attempted various strategies to improve this alignment, critical gaps still persist, highlighting the need for a comprehensive understanding of existing approaches and their effectiveness as a means to chart effective strategies to align physician workflows with EHRs. OBJECTIVE: This scoping review aims to identify and synthesize the strategies and tools health care organizations have used to align physician workflows with EHRs. This review will provide a toolkit for health care organizations and researchers, offering insights into effective alignment practices and identifying knowledge gaps for future research. METHODS: This scoping review will follow the Joanna Briggs Institute framework for scoping reviews while incorporating the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist for transparent reporting. We will search multiple databases, including MEDLINE, PubMed, Cochrane, CINAHL, Scopus, Embase, and Web of Science, for relevant literature on tools, strategies, and interventions used to align physician workflows with EHRs. The review will focus on studies involving physicians in direct patient care across primary, secondary, tertiary, and quaternary care settings. Two independent reviewers will screen titles, abstracts, and full texts for inclusion. Data extraction will be performed using a standardized form, and findings will be narratively synthesized and presented in tables and charts. RESULTS: The study is expected to provide a comprehensive toolkit of strategies, tools, and interventions for EHR-physician workflow alignment. This synthesis will offer health care organizations practical guidance for improving alignment and provide researchers with a foundation for identifying research gaps and future directions. The final report is planned for submission to an indexed journal in August 2025. CONCLUSIONS: This scoping review will offer valuable insights into the strategies and tools implemented by health care organizations to align EHRs with physician workflows. By assessing the effectiveness and limitations of these approaches, the review aims to contribute to improved EHR usability, reduced physician burnout, and enhanced patient care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/60464.

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