Cognitive artifacts in transition: An analysis of information content changes between manual and electronic patient tracking systems.

Today's emergency departments (ED) could not function without a patient tracking system of some kind, manual or electronic. Manual patient tracking systems such as "whiteboards" are large, dry erase, manually updated status boards used as information tracking devices in most EDs. Although it is expected that manual whiteboard systems will completely transition to electronic patient tracking systems with increasing availability of technological solutions, it is not clear if these technological solutions will sufficiently address the information tracking needs of providers. This study documents the changes in the use of a manual whiteboard versus an electronic patient tracking system in an ED to compare types of information and meanings of the represented information. Results show that both systems were used to represent information serving a variety of functional roles. In addition, an analysis of patient chief complaint entries indicates that manual whiteboards are used more dynamically than electronic systems. Differences in functional uses of the systems and the consequences of these changes are discussed.